Surgical instruments with double spherical articulation joints with pivotable links

ABSTRACT

Surgical instruments with articulation joints that include an articulation linkage assembly comprising a plurality of links configured to operably interface with a proximal joint member for movable travel relative thereto in a first proximal travel path and a second proximal travel path that are transverse to each other. The plurality of links are further configured to operably interface with a distal joint member for movable travel relative thereto in a first distal travel path and a second distal travel path that are transverse each other.

CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional application claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 63/057,430,entitled SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS,filed Jul. 28, 2020, of U.S. Provisional Patent Application Ser. No.63/057,432, entitled ARTICULATION JOINT ARRANGEMENTS FOR SURGICALINSTRUMENTS, filed Jul. 28, 2020, the disclosures of which areincorporated by reference herein in their entireties.

BACKGROUND

The present invention relates to surgical instruments and, in variousarrangements, to surgical stapling and cutting instruments and staplecartridges for use therewith that are designed to staple and cut tissue.The surgical instruments may be configured for use in open surgicalprocedures, but have applications in other types of surgery, such aslaparoscopic, endoscopic, and robotic-assisted procedures and mayinclude end effectors that are articulatable relative to a shaft portionof the instrument to facilitate precise positioning within a patient.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the various aspects are set forth withparticularity in the appended claims. The described aspects, however,both as to organization and methods of operation, may be best understoodby reference to the following description, taken in conjunction with theaccompanying drawings in which:

FIG. 1 is a perspective view of a surgical end effector portion of asurgical instrument in accordance with at least one aspect of thepresent disclosure;

FIG. 2 is a side view of the surgical end effector portion instrument ofFIG. 1 in a closed orientation;

FIG. 3 is an end view of the surgical end effector of FIG. 2 ;

FIG. 4 is a top view of the surgical end effector of FIG. 2 ;

FIG. 5 is an exploded assembly view of a portion of the surgicalinstrument of FIG. 1 ;

FIG. 6 is an exploded assembly view of an elongate shaft assembly of thesurgical instrument of FIG. 1 ;

FIG. 7 is another exploded assembly view of the elongate shaft assemblyof FIG. 6 ;

FIG. 8 is an exploded assembly view of a firing system and a rotarydrive system according to at least one aspect of the present disclosure;

FIG. 9 is a side view of a firing member and upper and lower flexiblespine assemblies of the firing system in engagement with a rotary drivescrew of the rotary drive system of FIG. 8 ;

FIG. 10 is a cross-sectional view of the firing member and upper andlower flexible spine assemblies of FIG. 9 ;

FIG. 11 is a side elevational view of the firing member and upper andlower flexible spine assemblies in engagement with the rotary drivescrew of FIG. 9 ;

FIG. 12 is a cross-sectional end view of the surgical end effector ofFIG. 4 taken along line 12-12 in FIG. 4 ;

FIG. 13 is an exploded perspective view of two adjacent upper vertebramembers of the upper flexible spine assembly of FIG. 10 ;

FIG. 14 is an exploded perspective view of two adjacent lower vertebramembers of the lower flexible spine assembly of FIG. 10 ;

FIG. 15 is a top view of a firing member and upper and lower flexiblespine assemblies in engagement with the rotary drive screw of FIG. 9 ;

FIG. 16 is a perspective view of a CV drive shaft assembly of the rotarydrive system of FIG. 8 in an articulated orientation;

FIG. 17 is a perspective view of the firing system of FIG. 8 in drivingengagement with the CV drive shaft assembly of FIG. 16 in accordancewith at least one aspect of the present disclosure;

FIG. 18 is a perspective view of a drive joint of the CV drive shaftassembly of FIG. 16 ;

FIG. 19 is a cross-sectional view of a portion of the surgicalinstrument of FIG. 4 taken along line 19-19 in FIG. 4 ;

FIG. 20 is a partial perspective view of a proximal end portion of thesurgical end effector and portions of the firing system and the rotarydrive system of the surgical instrument of FIG. 1 ;

FIG. 21 is a perspective view of the rotary drive system of the surgicalinstrument of FIG. 1 in driving engagement with the firing systemthereof in accordance with at least one aspect of the presentdisclosure;

FIG. 22 is an exploded perspective view of the rotary drive screw andthrust bearing arrangement of the firing system of FIG. 21 ;

FIG. 23 is a side view of the rotary drive screw of FIG. 22 ;

FIG. 24 is a partial cross-sectional side view of a portion of the lowerflexible spine assembly and a portion of the firing member of FIG. 21 indriving engagement with a portion of the rotary drive screw;

FIG. 25 is a perspective view of the firing member in a home or startingposition within the surgical end effector of the surgical instrument ofFIG. 1 ;

FIG. 26 is a side view illustrating the upper flexible spine assemblyand the lower flexible spine assembly of FIG. 21 in driving engagementwith the rotary drive screw after the firing member has been drivendistally from a home or starting position;

FIG. 27 is a partial cross-sectional perspective view of a portion ofthe surgical end effector, firing system and rotary drive system of thesurgical instrument of FIG. 1 according to at least one aspect of thepresent disclosure with an outer elastomeric joint assembly of anarticulation joint omitted for clarity;

FIG. 28 is another partial perspective view of a portion of the surgicalend effector, firing system and rotary drive system of FIG. 27 with anouter elastomeric joint assembly of an articulation joint and portionsof the elongate shaft assembly omitted for clarity;

FIG. 29 is a top view of the surgical end effector of FIG. 27articulated in a first direction relative to a portion of the elongateshaft assembly in accordance with at least one aspect of the presentdisclosure;

FIG. 30 is a side view of the surgical end effector of FIG. 29articulated in another direction relative to a portion of the elongateshaft assembly in accordance with at least one aspect of the presentdisclosure;

FIG. 31 is a perspective view of the surgical end effector of FIG. 29articulated in multiple planes with respect to a portion of the elongateshaft assembly in accordance with at least one aspect of the presentdisclosure;

FIG. 32 is a side elevational view of a portion of another surgicalinstrument that employs another outer elastomeric joint assembly inaccordance with at least one aspect of the present disclosure;

FIG. 33 is a partial cross-sectional perspective view of the surgicalinstrument of FIG. 32 ;

FIG. 34 is a perspective view of a portion of the outer elastomericjoint assembly of FIG. 32 ;

FIG. 35 is a cross-sectional end view of a portion of the surgicalinstrument of FIG. 19 taken along lines 35-35 in FIG. 19 ;

FIG. 36 is a cross-sectional end view of a portion of the surgicalinstrument of FIG. 19 taken along lines 36-36 in FIG. 19 ;

FIG. 37 is a partial cross-sectional view of a portion of an anvil capand an upper vertebra member of the surgical instrument of FIG. 19 inaccordance with at least one aspect of the present disclosure;

FIG. 38 is a side view of a portion of the surgical end effector of thesurgical instrument of FIG. 19 with an anvil thereof in an open positionin accordance with at least one aspect of the present disclosure andwith portions of the surgical end effector omitted for clarity;

FIG. 39 is a partial cross-sectional side view of the surgical endeffector of FIG. 38 with the anvil in an open position and the firingmember in the home or starting position in accordance with at least oneaspect of the present disclosure;

FIG. 40 is another partial cross-sectional side view of the surgical endeffector of FIG. 39 with the anvil in a partially closed position;

FIG. 41 is another partial cross-sectional side view of the surgical endeffector of FIG. 39 with the anvil in a fully closed position and thefiring member distally advancing through the surgical end effector;

FIG. 42 is a partial side elevational view of the surgical end effectorof FIG. 19 with portions thereof omitted for clarity to illustrate theanvil opening springs applying an opening motion to the anvil and withthe firing member in a home or starting position;

FIG. 43 is another partial side view of the surgical end effector ofFIG. 42 , after the firing member has moved proximally a short distanceto apply a quick closure motion to the anvil for grasping purposes;

FIG. 44 is a cross-sectional view of the surgical end effector of FIG.19 with the jaws thereof in a closed position and the firing memberthereof in a proximal-most position;

FIG. 45 is another cross-sectional view of the surgical end effector ofFIG. 44 , after the firing member has been distally advanced to theending position within the surgical end effector;

FIG. 46 is a perspective view of another articulation joint embodimentfor a surgical instrument with the joint in an unarticulatedorientation;

FIG. 47 is another perspective view of the articulation joint of FIG. 46in an articulated orientation;

FIG. 48 is an exploded assembly view of the articulation joint of FIG.46 ;

FIG. 49 is an end view of a proximal joint member of the articulationjoint of FIG. 46 ;

FIG. 50 is an end view of a distal joint member of the articulationjoint of FIG. 46 ;

FIG. 51 is a cross-sectional view of the proximal joint member of FIG.49 and a portion of a first link of the articulation joint in a firstposition;

FIG. 52 is another cross-sectional view of the proximal joint member ofFIG. 49 with the first link in another position;

FIG. 53 is another cross-sectional view of the proximal joint member andthe first link of FIG. 51 ;

FIG. 54 is another cross-sectional view of the proximal joint member andfirst link of FIG. 52 ;

FIG. 55 is another perspective view of the articulation joint of FIG. 46depicting virtual spheres for illustrating the articulation travelbetween a proximal portion of the articulation joint relative to adistal portion of the articulation joint;

FIG. 56 is another perspective view of the articulation joint of FIG. 55depicting the virtual spheres in relation to the proximal joint memberand distal joint member of the articulation joint of FIG. 46 ;

FIG. 57 is a perspective view of a portion of a surgical end effector ofa surgical instrument with an anvil thereof in an open position;

FIG. 58 is another perspective view of the surgical end effector of FIG.57 with a portion of the surgical end effector omitted to illustratepositions of various closure system components of the surgicalinstrument;

FIG. 59 is a cross-sectional view of the surgical end effector andclosure system components of FIG. 58 with the anvil in an open position;

FIG. 60 is another cross-sectional view of the surgical end effector andclosure system components of FIG. 58 with the anvil in a closedposition;

FIG. 61 is a perspective view of a closure cam member in a startingposition on a rotatable cam shaft corresponding to an open position ofthe anvil of the surgical end effector of FIG. 59 ;

FIG. 62 is another perspective view of the closure cam member in anending position on the rotatable cam shaft that corresponds to theclosed position of the anvil as shown in FIG. 60 ;

FIG. 63 is another perspective view of the surgical end effector of FIG.57 oriented in an articulated orientation about an articulation jointthat is attached thereto;

FIG. 64 is a top view of a distal joint portion of the articulationjoint of FIG. 63 articulated relative to a proximal articulation jointportion of the articulation joint of FIG. 63 ;

FIG. 65 is an exploded assembly view of the articulation joint of FIG.63 and a rotary drive assembly;

FIG. 66 is a cross-sectional view of the rotary drive assembly of FIG.65 ;

FIG. 67 is another cross-sectional view of the rotary drive assembly ofFIG. 66 ;

FIG. 68 is another perspective view of the surgical end effector andarticulation joint of FIG. 63 with portions thereof omitted for clarity;

FIG. 69 is an exploded assembly view of another surgical end effectorand rotary driven closure system;

FIG. 70 is a partial side view of a portion of the surgical end effectorand rotary drive closure system of FIG. 69 with the anvil in a closedorientation;

FIG. 71 is a partial perspective view of a portion of the surgical endeffector and rotary drive system of FIG. 69 with the anvil in an openorientation;

FIG. 72 is a partial end view of a portion of a rotary cam shaft and camfollower of the rotary drive system of FIG. 69 in a position when theanvil is in the open position;

FIG. 73 is another partial end view of the rotary cam shaft and camfollower of FIG. 72 after the closure process has started;

FIG. 74 is another partial end view of the rotary cam shaft and camfollower of FIG. 72 after a cam lobe on the rotary cam shaft has cammedthe cam follower into a position wherein the anvil is pivoted to an openposition;

FIG. 75 is another perspective view of a portion of the surgical endeffector and rotary drive system of FIG. 69 with the anvil in a closedposition;

FIG. 76 is a perspective view of another rotary cam shaft; and

FIG. 77 is a partial side elevational view of a portion of the surgicalend effector and rotary drive system of FIG. 69 employing the rotary camshaft of FIG. 76 and with the anvil in an open position.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. PatentApplications that were filed on even date herewith and which are eachherein incorporated by reference in their respective entireties:

-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH TORSION    SPINE DRIVE ARRANGEMENTS, U.S. patent application Ser. No.    17/360,133 filed on Jun. 28, 2021, issued as U.S. Pat. No.    11,638,582 on May 2, 2023;-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FIRING    MEMBER CLOSURE FEATURES, U.S. patent application Ser. No. 17/360,139    filed on Jun. 28, 2021, published as 2022/0031322 on Feb. 3, 2022;-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH SEGMENTED    FLEXIBLE DRIVE ARRANGEMENTS, U.S. patent application Ser. No.    17/360,149 filed on Jun. 28, 2021, issued as U.S. Pat. No.    11,660,090 on May 30, 2023;-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FLEXIBLE    BALL CHAIN DRIVE ARRANGEMENTS, U.S. patent application Ser. No.    17/360,162 filed on Jun. 28, 2021, published as U.S. Pub. No.    2022/0031319 on Feb. 3, 2022;-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DOUBLE    PIVOT ARTICULATION JOINT ARRANGEMENTS, U.S. patent application Ser.    No. 17/360,192 filed on Jun. 28, 2021, published as U.S. Pub. No.    2022/0031350 on Feb. 3, 2023;-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH    COMBINATION FUNCTION ARTICULATION JOINT ARRANGEMENTS, U.S. patent    application Ser. No. 17/360,197 filed on Jun. 28, 2021, published as    U.S. Pub. No. 2022/0031323 on Feb. 3, 2023;-   U.S. Patent Application entitled METHOD OF OPERATING A SURGICAL    INSTRUMENT, U.S. patent Ser. No. 17/360,199 filed on Jun. 28, 2021,    published as U.S. Pub. No. 2022/0031315 on Feb. 3, 2023;-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DUAL    SPHERICAL ARTICULATION JOINT ARRANGEMENTS, U.S. patent Ser. No.    17/360,211 filed on Jun. 28, 2021, published as U.S. Pub. No.    2022/0031324 on Feb. 3, 2023;-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FLEXIBLE    FIRING MEMBER ACTUATOR CONSTRAINT ARRANGEMENTS, U.S. patent Ser. No.    17/360,220 filed on Jun. 28, 2021, published as U.S. Pub. No.    2022/0031320 on Feb. 3, 2023;-   U.S. Patent Application entitled ARTICULATABLE SURGICAL INSTRUMENTS    WITH ARTICULATION JOINTS COMPRISING FLEXIBLE EXOSKELETON    ARRANGEMENTS, U.S. patent Ser. No. 17/360,244 filed on Jun. 28,    2021, published as U.S. Pub. No. 2022/0031346 on Feb. 3, 2023; and-   U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH    DIFFERENTIAL ARTICULATION JOINT ARRANGEMENTS FOR ACCOMMODATING    FLEXIBLE ACTUATORS, U.S. patent Ser. No. 17/360,249 filed on Jun.    28, 2021, published as U.S. Pub. No. 2022/0031351 on Feb. 3, 2023.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes” or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes” or “contains” one or more features possesses those oneor more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

References to items in the singular should be understood to includeitems in the plural, and vice versa, unless explicitly stated otherwiseor clear from the text. Grammatical conjunctions are intended to expressany and all disjunctive and conjunctive combinations of conjoinedclauses, sentences, words, and the like, unless otherwise stated orclear from the context. Thus, the term “or” should generally beunderstood to mean “and/or”, etc.

Recitation of ranges of values herein are not intended to be limiting,referring instead individually to any and all values falling within therange, unless otherwise indicated herein, and each separate value withinsuch a range is incorporated into the disclosure as if it wereindividually recited herein. The words “about,” “approximately” or thelike, when accompanying a numerical value, are to be construed asindicating a deviation as would be appreciated by one of ordinary skillin the art to operate satisfactorily for an intended purpose. Similarly,words of approximation such as “approximately” or “substantially” whenused in reference to physical characteristics, should be construed tocontemplate a range of deviations that would be appreciated by one ofordinary skill in the art to operate satisfactorily for a correspondinguse, function, purpose or the like.

The use of any and all examples, or exemplary language (“e.g.,” “suchas,” or the like) provided herein, is intended merely to betterilluminate the embodiments and does not pose a limitation on the scopeof the embodiments. No language in the specification should be construedas indicating any unclaimed element as essential to the practice of theembodiments.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various instruments disclosed hereincan be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the instruments can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongate shaft of a surgical instrument can be advanced.

It is common practice during various laparoscopic surgical procedures toinsert a surgical end effector portion of a surgical instrument througha trocar that has been installed in the abdominal wall of a patient toaccess a surgical site located inside the patient's abdomen. In itssimplest form, a trocar is a pen-shaped instrument with a sharptriangular point at one end that is typically used inside a hollow tube,known as a cannula or sleeve, to create an opening into the body throughwhich surgical end effectors may be introduced. Such arrangement formsan access port into the body cavity through which surgical end effectorsmay be inserted. The inner diameter of the trocar's cannula necessarilylimits the size of the end effector and drive-supporting shaft of thesurgical instrument that may be inserted through the trocar.

Regardless of the specific type of surgical procedure being performed,once the surgical end effector has been inserted into the patientthrough the trocar cannula, it is often necessary to move the surgicalend effector relative to the shaft assembly that is positioned withinthe trocar cannula in order to properly position the surgical endeffector relative to the tissue or organ to be treated. This movement orpositioning of the surgical end effector relative to the portion of theshaft that remains within the trocar cannula is often referred to as“articulation” of the surgical end effector. A variety of articulationjoints have been developed to attach a surgical end effector to anassociated shaft in order to facilitate such articulation of thesurgical end effector. As one might expect, in many surgical procedures,it is desirable to employ a surgical end effector that has as large arange of articulation as possible.

Due to the size constraints imposed by the size of the trocar cannula,the articulation joint components must be sized so as to be freelyinsertable through the trocar cannula. These size constraints also limitthe size and composition of various drive members and components thatoperably interface with the motors and/or other control systems that aresupported in a housing that may be handheld or comprise a portion of alarger automated system. In many instances, these drive members mustoperably pass through the articulation joint to be operably coupled toor operably interface with the surgical end effector. For example, onesuch drive member is commonly employed to apply articulation controlmotions to the surgical end effector. During use, the articulation drivemember may be unactuated to position the surgical end effector in anunarticulated position to facilitate insertion of the surgical endeffector through the trocar and then be actuated to articulate thesurgical end effector to a desired position once the surgical endeffector has entered the patient.

Thus, the aforementioned size constraints form many challenges todeveloping an articulation system that can effectuate a desired range ofarticulation, yet accommodate a variety of different drive systems thatare necessary to operate various features of the surgical end effector.Further, once the surgical end effector has been positioned in a desiredarticulated position, the articulation system and articulation jointmust be able to retain the surgical end effector in that locked positionduring the actuation of the end effector and completion of the surgicalprocedure. Such articulation joint arrangements must also be able towithstand external forces that are experienced by the end effectorduring use.

A variety of surgical end effectors exist that are configured to cut andstaple tissue. Such surgical end effectors commonly include a first jawfeature that supports a surgical staple cartridge and a second jaw thatcomprises an anvil. The jaws are supported relative to each other suchthat they can move between an open position and a closed position toposition and clamp target tissue therebetween. Many of these surgicalend effectors employ an axially moving firing member. In some endeffector designs, the firing member is configured to engage the firstand second jaws such that as the firing member is initially advanceddistally, the firing member moves the jaws to the closed position. Otherend effector designs employ a separate closure system that isindependent and distinct from the system that operates the firingmember.

The staple cartridge comprises a cartridge body. The cartridge bodyincludes a proximal end, a distal end, and a deck extending between theproximal end and the distal end. In use, the staple cartridge ispositioned on a first side of the tissue to be stapled and the anvil ispositioned on a second side of the tissue. The anvil is moved toward thestaple cartridge to compress and clamp the tissue against the deck.Thereafter, staples removably stored in the cartridge body can bedeployed into the tissue. The cartridge body includes staple cavitiesdefined therein wherein staples are removably stored in the staplecavities. The staple cavities are arranged in six longitudinal rows.Three rows of staple cavities are positioned on a first side of alongitudinal slot and three rows of staple cavities are positioned on asecond side of the longitudinal slot. Other arrangements of staplecavities and staples may be possible.

The staples are supported by staple drivers in the cartridge body. Thedrivers are movable between a first, or unfired position, and a second,or fired, position to eject the staples from the staple cavities. Thedrivers are retained in the cartridge body by a retainer which extendsaround the bottom of the cartridge body and includes resilient membersconfigured to grip the cartridge body and hold the retainer to thecartridge body. The drivers are movable between their unfired positionsand their fired positions by a sled. The sled is movable between aproximal position adjacent the proximal end and a distal positionadjacent the distal end. The sled comprises a plurality of rampedsurfaces configured to slide under the drivers and lift the drivers, andthe staples supported thereon, toward the anvil.

Further to the above, in these surgical end effectors, the sled is moveddistally by the firing member. The firing member is configured tocontact the sled and push the sled toward the distal end. Thelongitudinal slot defined in the cartridge body is configured to receivethe firing member. The anvil also includes a slot configured to receivethe firing member. The firing member further comprises a first cam whichengages the first jaw and a second cam which engages the second jaw. Asthe firing member is advanced distally, the first cam and the second camcan control the distance, or tissue gap, between the deck of the staplecartridge and the anvil. The firing member also comprises a knifeconfigured to incise the tissue captured intermediate the staplecartridge and the anvil. It is desirable for the knife to be positionedat least partially proximal to the ramped surfaces such that the staplesare ejected ahead of the knife.

Many surgical end effectors employ an axially movable firing beam thatis attached to the firing member and is used to apply axial firing andretraction motions to the firing member. Many of such firing beamscomprise a laminated construction that affords the firing beam with somedegree of flexure about the articulation joint. As the firing beamtraverses the articulation joint, the firing beam can applyde-articulation forces to the joint and can cause the beam to buckle. Toprevent the firing beam from buckling under pressure, the articulationjoint is commonly provided with lateral supports or “blow-out” platefeatures to support the portion of the beam that traverses thearticulation joint. To advance the firing beam through an angle ofgreater than sixty degrees, for example, a lot of axial force isrequired. This axial force must be applied to the firing member in abalanced manner to avoid the firing member from binding with the jaws asthe firing member moves distally. Any binding of the firing member withthe jaws can lead to component damage and wear as well as require anincreased amount of axial drive force to drive the firing member throughthe clamped tissue.

Other end effector designs employ a firing member that is rotarypowered. In many of such designs, a rotary drive shaft extends throughthe articulation joint and interfaces with a rotatable firing memberdrive shaft that is rotatably supported within one of the jaws. Thefiring member threadably engages the rotatable firing member drive shaftand, as the rotatable firing member drive shaft is rotated, the firingmember is driven through the end effector. Such arrangements require thesupporting jaw to be larger to accommodate the firing member driveshaft. In such devices, a lower end of the firing member commonlyoperably interfaces with the drive shaft which can also result in anapplication of forces that tend to unbalance the firing member as it isdriven distally.

FIGS. 1-4 illustrate one form of a surgical instrument 10 that mayaddress many of the challenges facing surgical instruments witharticulatable end effectors that are configured to cut and fastentissue. In various embodiments, the surgical instrument 10 may comprisea handheld device. In other embodiments, the surgical instrument 10 maycomprises an automated system sometimes referred to as arobotically-controlled system, for example. In various forms, thesurgical instrument 10 comprises a surgical end effector 1000 that isoperably coupled to an elongate shaft assembly 2000. The elongate shaftassembly 2000 may be operably attached to a housing 2002. In oneembodiment, the housing 2002 may comprise a handle that is configured tobe grasped, manipulated, and actuated by the clinician. In otherembodiments, the housing 2002 may comprise a portion of a robotic systemthat houses or otherwise operably supports at least one drive systemthat is configured to generate and apply at least one control motionwhich could be used to actuate the surgical end effectors disclosedherein and their respective equivalents. In addition, various componentsmay be “housed” or contained in the housing or various components may be“associated with” a housing. In such instances, the components may notbe contained with the housing or supported directly by the housing. Forexample, the surgical instruments disclosed herein may be employed withvarious robotic systems, instruments, components and methods disclosedin U.S. Pat. No. 9,072,535, entitled SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, which is incorporated byreference herein in its entirety.

In one form, the surgical end effector 1000 comprises a first jaw 1100and a second jaw 1200. In the illustrated arrangement, the first jaw1100 comprises an elongate channel 1110 that comprises a proximal end1112 and a distal end 1114 and is configured to operably support asurgical staple cartridge 1300 therein. The surgical staple cartridge1300 comprises a cartridge body 1302 that has an elongate slot 1304therein. A plurality of surgical staples or fasteners (not shown) arestored therein on drivers (not shown) that are arranged in rows on eachside of the elongate slot 1304. The drivers are each associated withcorresponding staple cavities 1308 that open through a cartridge decksurface 1306. The surgical staple cartridge 1300 may be replaced afterthe staples/fasteners have been discharged therefrom. Other embodimentsare contemplated wherein the elongate channel 1110 and/or the entiresurgical end effector 1000 may is discarded after the surgical staplecartridge 1300 has been used. Such end effector arrangements may bereferred to as “disposable loading units”, for example.

In the illustrated arrangement, the second jaw 1200 comprises an anvil1210 that comprises an elongate anvil body 1212 that comprises aproximal end 1214 and a distal end 1216. In one arrangement, a pair ofstiffening rods or members 1213 may be supported in the anvil body 1212to provide the anvil body 1212 with added stiffness and rigidity. Theanvil body 1212 comprises a staple-forming undersurface 1218 that facesthe first jaw 1100 and may include a series of staple-forming pockets(not shown) that corresponds to each of the staples or fasteners in thesurgical staple cartridge 1300. The anvil body 1212 may further includea pair of downwardly extending tissue stop features 1220 that are formedadjacent the proximal end 1214 of the anvil body 1212. One tissue stopfeature 1220 extends from each side of the anvil body 1212 such that adistal end 1222 on each tissue stop corresponds to the proximal-moststaples/fasteners in the surgical staple cartridge 1300. When the anvil1210 is moved to a closed position onto tissue positioned between thestaple-forming undersurface 1218 of the anvil 1210 and the cartridgedeck surface 1306 of the surgical staple cartridge 1300, the tissuecontacts the distal ends 1222 of the tissue stop features 1220 toprevent the tissue from migrating proximally past the proximal-moststaples/fasteners to thereby ensure that the tissue that is cut is alsostapled. When the surgical staple cartridge is “fired” as will bediscussed in further detail below, the staples/fasteners supportedwithin each staple cavity are driven out of the staple cavity 1308through the clamped tissue and into forming contact with thestaple-forming undersurface 1218 of the anvil 1210.

As can be seen in FIGS. 5 and 6 , the proximal end 1214 of the anvilbody 1212 comprises an anvil mounting portion 1230 that includes a pairof laterally extending mounting pins 1232 that are configured to bereceived in corresponding mounting cradles or pivot cradles 1120 formedin the proximal end 1112 of the elongate channel 1110. The mounting pins1232 are pivotally retained within the mounting cradles 1120 by an anvilcap 1260 that may be attached to the proximal end 1112 of the elongatechannel 1110 by mechanical snap features 1261 that are configured toengage retention formations 1113 on the elongate channel 1110. See FIG.5 . In other arrangements, the anvil cap 1260 may be attached to theelongate channel 1110 by welding, adhesive, etc. Such arrangementfacilitates pivotal travel of the anvil 1210 relative to the surgicalstaple cartridge 1300 mounted in the elongate channel 1110 about a pivotaxis PA between an open position (FIG. 1 ) and a closed position (FIGS.2-5 ). Such pivot axis PA may be referred to herein as being “fixed” inthat the pivot axis does not translate or otherwise move as the anvil1200 is pivoted from an open position to a closed position.

In the illustrated arrangement, the elongate shaft assembly 2000 definesa shaft axis SA and comprises a proximal shaft portion 2100 that mayoperably interface with a housing of the control portion (e.g., handheldunit, robotic tool driver, etc.) of the surgical instrument 10. Theelongate shaft assembly 2000 further comprises an articulation joint2200 that is attached to the proximal shaft portion 2100 and thesurgical end effector 1000. In various instances, the proximal shaftportion 2100 comprises a hollow outer tube 2110 that may be operablycoupled to a housing 2002. See FIG. 2 . As can be seen in FIG. 6 , theproximal shaft portion 2100 may further comprise a rigid proximalsupport shaft 2120 that is supported within the hollow outer tube 2110and extends from the housing to the articulation joint 2200. Theproximal support shaft 2120 may comprise a first half 2120A and a secondhalf 2120B that may be coupled together by, for example, welding,adhesive, etc. The proximal support member 2120 comprises a proximal end2122 and a distal end 2124 and includes an axial passage 2126 thatextends therethrough from the proximal end 2122 to the distal end 2124.

As was discussed above, many surgical end effectors employ a firingmember that is pushed distally through a surgical staple cartridge by anaxially movable firing beam. The firing beam is commonly attached to thefiring member in the center region of the firing member body. Thisattachment location can introduce an unbalance to the firing member asit is advanced through the end effector. Such unbalance can lead toundesirable friction between the firing member and the end effectorjaws. The creation of this additional friction may require anapplication of a higher firing force to overcome such friction as wellas can cause undesirable wear to portions of the jaws and/or the firingmember. An application of higher firing forces to the firing beam mayresult in unwanted flexure in the firing beam as it traverses thearticulation joint. Such additional flexure may cause the articulationjoint to de-articulate—particularly when the surgical end effector isarticulated at relatively high articulation angles. The surgicalinstrument 10 employs a firing system 2300 that may address many if notall of these issues as well as others.

As can be seen in FIGS. 5-11 , in at least one embodiment, the firingsystem 2300 comprises a firing member 2310 that includes avertically-extending firing member body 2312 that comprises a top firingmember feature 2320 and a bottom firing member feature 2350. A tissuecutting blade 2314 is attached to or formed in the vertically-extendingfiring member body 2312. See FIGS. 9 and 11 . In at least onearrangement, it is desirable for the firing member 2310 to pass throughthe anvil body 1212 with low friction, high strength and high stiffness.In the illustrated arrangement, the top firing member feature 2320comprises a top tubular body 2322 that has a top axial passage 2324extending therethrough. See FIG. 10 . The bottom firing member feature2350 comprises a bottom tubular body 2352 that has a bottom axialpassage 2354 extending therethrough. In at least one arrangement, thetop firing member feature 2320 and the bottom firing member feature 2350are integrally formed with the vertically-extending firing member body2312. As can be seen in FIG. 12 , the anvil body 1212 comprises anaxially extending anvil slot 1240 that has a cross-sectional shape thatresembles a “keyhole”. Similarly, the elongate channel 1110 comprises anaxially extending channel slot 1140 that also has a keyholecross-sectional shape.

Traditional firing member arrangements employ long flexible cantileverwings that extend from a top portion and a bottom portion of the firingmember. These cantilever wings slidably pass through slots in the anviland channel that are commonly cut with a rectangular t-cutter whichtended to produce higher friction surfaces. Such long cantilever wingshave minimum surface area contact with the anvil and channel and canresult in galling of those components. The keyhole-shaped channel slot1140 and keyhole-shaped anvil slot 1240 may be cut with a round t-cutterand may be finished with a reamer/borer which will result in thecreation of a lower friction surface. In addition, the top tubular body2322 and the bottom tubular body 2352 tend to be stiffer than the priorcantilever wing arrangements and have increased surface area contactwith the anvil and channel, respectively which can reduce galling andlead to a stronger sliding connection. Stated another way, because theanvil slot 1240 and the channel slot 1140 are keyhole-shaped and haveless material removed than a traditional rectangular slot, the geometryand increased material may result in a stiffer anvil and channel whencompared to prior arrangements.

Turning to FIGS. 9-11 , in one arrangement, the firing system 2300further comprises an upper flexible spine assembly 2400 that is operablycoupled to the top firing member feature 2320 and a lower flexible spineassembly 2500 that is operably coupled to the bottom firing memberfeature 2350. In at least one embodiment, the upper flexible spineassembly 2400 comprises an upper series 2410 of upper vertebra members2420 that are loosely coupled together by an upper flexible couplermember 2402 that is attached to the top firing member feature 2320. Theupper flexible coupler member 2402 may comprises a top cable 2404 thatextends through the top axial passage 2324 in the top firing memberfeature 2320 and a distal end 2406 of the top cable 2404 is attached toa retainer ferrule 2408 that is secured with the top axial passage 2324.

As can be seen in FIG. 13 , each upper vertebra member 2420 comprises anupper vertebra body portion 2422 that has a proximal end 2424 and adistal end 2428. An upper hollow passage 2429 extends through the uppervertebra body portion 2422 to accommodate passage of the upper flexiblecoupler member 2402 therethrough. Each upper vertebra member 2420further comprises a downwardly extending upper drive feature or uppervertebra member tooth 2450 that protrudes from the upper vertebra bodyportion 2422. Each upper vertebra member tooth 2450 has a helix-shapedproximal upper face portion 2452 and a helix-shaped distal upper faceportion 2454. Each proximal end 2424 of the upper vertebra body portions2422 has an upper proximal mating feature 2426 therein and each distalend 2428 has an upper distal mating feature 2430 formed therein. In atleast one embodiment, the upper proximal mating feature 2426 comprises aconcave recess 2427 and each upper distal mating feature 2430 comprisesa convex mound 2431. When arranged in the upper series 2410, the convexmound 2431 on one upper vertebra member 2420 contacts and mates with theconcave recess 2427 on an adjacent upper vertebra member 2420 in theupper series 2410 to maintain the upper vertebra members 2420 roughly inalignment so that the helix-shaped proximal upper face portion 2452 anda helix-shaped distal upper face portion 2454 on each respective uppertooth 2450 can be drivingly engaged by a rotary drive screw 2700 as willbe discussed in further detail below.

Similarly, in at least one embodiment, the lower flexible spine assembly2500 comprises a lower series 2510 of lower vertebra members 2520 thatare loosely coupled together by a lower flexible coupler member 2502that is attached to the bottom firing member feature 2350. The lowerflexible coupler member 2502 may comprises a lower cable 2504 thatextends through the bottom axial passage 2354 in the bottom firingmember feature 2350 and a distal end 2506 of the bottom cable 2504 isattached to a retainer ferrule 2508 that is secured with the bottomaxial passage 2354.

As can be seen in FIG. 14 , each lower vertebra member 2520 comprises alower vertebra body portion 2522 that has a proximal end 2524 and adistal end 2528. A lower hollow passage 2529 extends through the lowervertebra body portion 2522 to accommodate passage of the lower flexiblecoupler member 2502 therethrough. Each lower vertebra member 2520further comprises an upwardly extending lower drive feature or lowervertebra member tooth 2550 that protrudes upward from the lower vertebrabody portion 2522. Each lower vertebra member tooth 2550 has ahelix-shaped proximal lower face portion 2552 and a helix-shaped distallower face portion 2554. Each proximal end 2524 of the lower vertebrabody portions 2522 has a lower proximal mating feature 2526 therein andeach distal end 2528 has a lower distal mating feature 2530 formedtherein. In at least one embodiment, the lower proximal mating feature2526 comprises a concave recess 2527 and each lower distal matingfeature 2530 comprises a convex mound 2531. When arranged in the lowerseries 2510, the convex mound 2531 on one lower vertebra member 2520contacts and mates with the concave recess 2527 on an adjacent lowervertebra member 2520 in the lower series 2510 to maintain the lowervertebra members 2520 roughly in alignment so that the helix-shapedproximal lower face portion 2552 and a helix-shaped distal lower faceportion 2554 on each respective lower vertebra member tooth 2550 can bedrivingly engaged by a rotary drive screw 2700 as will be discussed infurther detail below.

Now turning to FIGS. 5, 7, and 8 , in at least one arrangement, thefiring drive system 2300 further comprises a rotary drive screw 2700that is configured to drivingly interface with the upper series 2410 ofupper vertebra members 2420 and the lower series 2510 of lower vertebramembers 2520. In the illustrated arrangement, the rotary drive screw2700 is driven by a rotary drive system 2600 that comprises a proximalrotary drive shaft 2610 that is rotatably supported within the axialpassage 2126 within the proximal support shaft 2120. See FIG. 7 . Theproximal rotary drive shaft 2610 comprises a proximal end 2612 and adistal end 2614. The proximal end 2612 may interface with a gear box2004 or other arrangement that is driven by a motor 2006 or other sourceof rotary motion housed in the housing of the surgical instrument. SeeFIG. 2 . Such source of rotary motion causes the proximal rotary driveshaft to rotate about the shaft axis SA within the axial passage 2126 inthe proximal support shaft 2120.

The proximal rotary drive shaft 2610 is operably supported within theelongate shaft assembly 2000 in a location that is proximal to thearticulation joint 2200 and operably interfaces with a constant velocity(CV) drive shaft assembly 2620 that spans or extends axially through thearticulation joint 2200. As can be seen in FIGS. 8, 16, and 17 , in atleast one arrangement, the CV drive shaft assembly 2620 comprises aproximal CV drive assembly 2630 and a distal CV drive shaft 2670. Theproximal CV drive assembly 2630 comprises a proximal shaft segment 2632that consists of an attachment shaft 2634 that is configured to benon-rotatably received within a similarly-shaped coupler cavity 2616 inthe distal end 2614 of the proximal rotary drive shaft 2610. Theproximal shaft segment 2632 operably interfaces with a series 2640 ofmovably coupled drive joints 2650.

As can be seen in FIG. 18 , in at least one arrangement, each drivejoint 2650 comprises a first or distal sphere portion 2660 and a secondor proximal sphere portion 2652. The distal sphere portion 2660 islarger than the proximal sphere portion 2652. The distal sphere portion2660 comprises a socket cavity 2662 that is configured to rotatablyreceive a proximal sphere portion 2652 of an adjacent drive joint 2650therein. Each proximal sphere portion 2652 comprises a pair ofdiametrically opposed joint pins 2654 that are configured to be movablyreceived in corresponding pin slots 2664 in the distal sphere portion2660 of an adjacent drive joint 2650 as can be seen in FIG. 16 . Aproximal sphere portion 2652P of a proximal-most drive joint 2650P isrotatably received in a distal socket portion 2636 of the proximal shaftsegment 2632 as shown in FIG. 16 . The joint pins 2654P are receivedwithin corresponding pin slots 2637 in the distal socket portion 2636.As can be further seen in FIG. 16 , a distal-most drive joint 2650D inthe series 2640 of movably coupled drive joints 2650 is movably coupledto a distal CV drive shaft 2670.

In at least one arrangement, the distal CV drive shaft 2670 comprises aproximal sphere portion 2672 that is sized to be movably received in thesocket cavity 2662D in the distal-most drive joint 2650D. The proximalsphere portion 2672 includes joint pins 2674 that are movably receivedin the pin slots 2664D in the distal-most drive joint 2650D. The distalCV drive shaft 2670 further comprises a distally extending shaft stem2676 that is configured to be non-rotatably coupled to the rotary drivescrew 2700 that is positioned distal to the articulation joint 2200. Thedistal CV drive shaft 2670 includes a flange 2677 and a mounting barrelportion 2678 for receiving a thrust bearing housing 2680 thereon.

In the illustrated arrangement, when the series 2640 of movably coupleddrive joints 2650 articulates, the joint pins 2674 remain in thecorresponding pin slots 2664 of an adjacent drive joint 2650. In theexample illustrated in FIG. 18 , each drive joint may be capable ofapproximately eighteen degrees of articulation in the pitch and yawdirections. FIG. 16 illustrates an angle of the series of 2640 of drivejoints 2650 when each drive joint 2650 in the series are fullyarticulated ninety degrees in pitch and yaw which yields an angle α ofapproximately 100.9 degrees. In such arrangement, the outer surface ofeach distal sphere portion 2660 clears the outer surface of the adjacentor adjoining proximal sphere portion 2652 allowing for unrestrictedmotion until the eighteen degree limit is reached. The rigid design andlimited small angles allow the series 2640 of movably coupled drivejoints 2650 to carry high loads torsionally at an overall large angle.

In the illustrated arrangement, the articulation joint 2200 comprises anarticulation joint spring 2230 that is supported within an outerelastomeric joint assembly 2210. The outer elastomeric joint assembly2210 comprises a distal end 2212 that is attached to the proximal end1112 of the elongate channel 1110. For example, as can be seen in FIG. 6, the distal end 2212 of the outer elastomeric joint assembly 2210 isattached to the proximal end 1112 of the elongate channel 1110 by a pairof cap screws 2722 that extend through a distal mounting bushing 2720 tobe threadably received in the proximal end 1112 of the elongate channel1110. A proximal end 2214 of the elastomeric joint assembly 2210 isattached to the distal end 2124 of the proximal support shaft 2120. Theproximal end 2214 of the elastomeric joint assembly 2210 is attached tothe distal end 2124 of the proximal support member 2120 by a pair of capscrews 2732 that extend through a proximal mounting bushing 2750 to bethreadably received in threaded inserts 2125 mounted within the distalend 2124 of the proximal support shaft 2120.

To prevent the drive joints 2650 from buckling during articulation, theseries 2640 of movably coupled drive joints 2650 extend through at leastone low friction articulation joint spring 2730 that is supported withinthe outer elastomeric joint assembly 2210. See FIG. 19 . Thearticulation joint spring 2730 is sized relative to the drive joints2650 such that a slight radial clearance is provided between thearticulation joint spring 2730 and the drive joints 2650. Thearticulation joint spring 2730 is designed to carry articulation loadsaxially which may be significantly lower than the torsional firingloads. The joint spring(s) is longer than the series 2640 of drivejoints 2650 such that the drive joints are axially loose. If the “hardstack” of the series 2640 of drive joints 2650 is longer than thearticulation joint spring(s) 2730 hard stack, then the drive joints 2650may serve as an articulation compression limiter causing firing loadsand articulation loads to resolve axially through the series 2640 of thedrive joints 2650. When the firing loads resolve axially through theseries 2640 of the drive joints 2650, the loads may try to straightenthe articulation joint 2200 or in other words cause de-articulation. Ifthe hard stack of the articulation joint spring(s) 2730 is longer thanthe hard stack of the series 2640 of the drive joints 2650, the firingloads will then be contained within the end effector and no firing loadswill resolve through the drive joints 2650 or through the springs(s)2730.

To further ensure that the drive joints 2650 are always engaged witheach other, a proximal drive spring 2740 is employed to apply an axialbiasing force to the series 2640 of drive joints 2650. For example, ascan be seen in FIGS. 8, 19, and 20 , the proximal drive spring 2740 ispositioned between the proximal mounting bushing 2734 and a supportflange that is formed between the distal socket portion 2636 and aproximal barrel portion 2638 of the proximal shaft segment 2632. In onearrangement, the proximal drive spring 2740 may comprise an elastomericO-ring/bushing received on the proximal barrel portion 2638 of theproximal shaft segment 2632. The proximal drive spring 2740 lightlybiases the drive joints 2650 together to decrease any gaps that mayoccur during articulation. This ensures that the drive joints 2650transfer loads torsionally. It will be appreciated, however, that in atleast one arrangement, the proximal drive spring 2740 does not apply ahigh enough axial load to cause firing loads to translate through thearticulation joint 2200.

As can be seen in FIGS. 9 and 10 , the top firing member feature 2320 onthe firing member 2310 comprises a distal upper firing member toothsegment 2330 that is equivalent to one half of an upper tooth 2450 oneach upper vertebra member 2420. In addition, a proximal upper firingmember tooth 2336 that is identical to an upper tooth 2450 on each uppervertebra member 2420 is spaced from the distal upper firing member toothsegment 2330. The distal upper firing member tooth segment 2330 and theproximal upper firing member tooth 2336 may be integrally formed withthe top firing member feature 2320 of the firing member 2310. Likewise,the bottom firing member feature 2350 of the firing member 2310comprises a distal lower firing member tooth 2360 and a proximal lowerfiring member tooth 2366 that are integrally formed on the bottom firingmember feature 2350. For example, in at least one arrangement, thefiring member 2310 with the rigidly attached teeth 2330, 2336, 2360, and2366 may be fabricated at one time as one unitary component usingconventional metal injection molding techniques.

As indicated above, each of the upper vertebra members 2520 is movablyreceived on an upper flexible coupler member 2402 in the form of a topcable 2404. As was described above, the distal end 2406 of the top cable2404 is secured to the top firing member feature 2320 of the firingmember 2310. Similarly, each of the lower vertebra members 2520 ismovably received on a lower flexible coupler member 2502 in the form ofa lower cable 2504. A distal end 2506 of the lower cable 2504 is securedto the bottom firing member feature 2350 of the firing member 2310. Inat least one arrangement, the top cable 2404 and the bottom cable 2504extend through the proximal shaft portion 2100 and, as will be discussedin further detail below, may interface with a bailout arrangementsupported in the housing for retracting the firing member 2310 back toits home or starting position should the firing member drive systemfail.

Turning again to FIG. 8 , the axial length AL_(u) of the upper series2410 of upper vertebra members 2420 and the axial length AL_(l) of thelower series 2510 of lower vertebra members 2520 are equal and must besufficiently long enough to facilitate the complete distal advancementof the firing member 2310 from the home or starting position to adistal-most ending position within the staple cartridge while theproximal-most upper vertebra members 2420 in the upper series 2410 ofupper vertebra members 2420 and the proximal-most lower vertebra members2520 in the lower series 2510 of lower vertebra members 2520 remain indriving engagement with the rotary drive screw 2700. As can be seen inFIG. 8 , an upper compression limiting spring 2421 is configured tointerface with a proximal-most upper vertebra member 2420P in the upperseries 2410 of upper vertebra members 2420. The upper compressionlimiting spring 2421 is journaled on the top cable 2404 and is retainedin biasing engagement with the proximal-most upper vertebra member 2420Pby an upper spring holder 2423 that is retained in position by an upperferrule 2425 that is crimped onto the top cable 2404. The top cable 2404extends through an upper hypotube 2433 that is supported in the proximalsupport shaft. Likewise, a lower compression limiting spring 2521 isconfigured to interface with a proximal-most, lower vertebra member2520P in the lower series 2510 of lower vertebra members 2520. The lowercompression spring 2521 is journaled on the lower cable 2504 and isretained in biasing engagement with the proximal-most, lower vertebramember 2520P by a lower spring holder 2523 that is retained in positionby a lower ferrule 2525 that is crimped onto the lower cable 2504. Thelower cable 2504 extends through a lower hypotube 2533 that is supportedin the proximal support shaft.

When the upper vertebra members 2420 and the lower vertebra members 2520angle through the articulation joint (after the end effector has beenpositioned in an articulated position), the gaps between the respectivevertebra members 2420, 2520 increase in each series 2410, 2510 whichcauses the springs 2421, 2521 to become tighter. The compressionlimiting springs 2421, 2521 provide enough slack in the cables 2404,2504, respectively to enable the vertebra members 2420, 2520 anglethrough the most extreme articulation angles. If the cables 2404, 2504are pulled too tight, the spring holders 2423, 2523 will contact theirrespective proximal-most vertebra members 2420P, 2520P. Such compressionlimiting arrangements ensure that the vertebra members 2420, 2520 intheir respective series 2410, 2510 always remain close enough togetherso that the rotary drive screw 2700 will always drivingly engage them inthe manner discussed in further detail below. When the vertebra members2420, 2520 are aligned straight again, the compression limiting springs2421, 2521 may partially relax while still maintaining some compressionbetween the vertebra members.

As indicated above, when the upper vertebra members 2420 are arranged inthe upper series 2410 and lower vertebra members 2520 are arranged inthe lower series 2510, the convex mounds and concave recesses in eachvertebra member as well as the compression limiter springs serve tomaintain the upper and lower vertebra members in relatively linearalignment for driving engagement by the rotary drive screw 2700. As canbe seen in FIGS. 9 and 10 , when the upper vertebra members 2420 are inlinear alignment, the upper teeth 2450 are spaced from each other by anopening space generally designated as 2460 that facilitates drivingengagement with the helical drive thread 2170 on the rotary drive screw.Similarly, when the lower vertebra members 2520 are in linear alignment,the lower vertebra member teeth 2550 are spaced from each other by anopening space generally designated as 2560 that facilitates drivingengagement with the helical drive thread 2170 of the rotary drive screw2700.

Turning to FIGS. 8 and 22 , the rotary drive screw 2700 comprises ascrew body 2702 that has a socket 2704 therein for receiving thedistally extending shaft stem 2676 of the distal CV drive shaft 2670. Aninternal radial groove 2714 (FIG. 10 ) is formed in the screw body 2702for supporting a plurality of ball bearings 2716 therein. In onearrangement, for example, 12 ball bearings 2716 are employed. The radialgroove 2714 supports the ball bearings 2716 between the screw body 2702and a distal end of the thrust bearing housing 2680. The ball bearings2716 serve to distribute the axial load of the rotary drive screw 2700and significantly reduce friction through the balls' rolling motion.

As can be seen in FIG. 23 , a helical drive thread 2710 is providedaround the screw body 2702 and serves to form a proximal thread scoopfeature 2712. The proximal thread scoop feature 2712 is formed with afirst pitch 2713 and the remaining portion of the helical drive thread2710 is formed with a second pitch 2715 that differs from the firstpitch 2713. In FIGS. 22 and 23 , area 2718 illustrates where the firstpitch 2713 and the second pitch 2715 converge. In at least oneembodiment, the first pitch 2713 is larger than the second pitch 2715 toensure that the rotary drive screw 2700 captures and “scoops up” ordrivingly engages every upper vertebra member 2420 and every lowervertebra member 2520. As can be seen in FIG. 24 , a proximal end 2717 ofthe helical drive thread 2710 that has the first pitch 2713 has scoopedinto the into the opening space 2560 between two adjacent lower vertebramember teeth 2550A and 2550B while the center portion 2719 of thehelical drive thread 2710 that has the second pitch 2715 is in drivingengagement with the helix-shaped distal lower face portion 2554 on thelower vertebra member tooth 2550B and the helix-shaped proximal lowerface portion 2552 on the proximal lower firing member tooth 2366. As canalso be appreciated, the scoop feature 2712 may not contact thehelix-shaped distal lower face portion 2554A of the lower vertebramember tooth 2550A as it scoops up the lower vertebra member tooth 2550Bwhen driving the firing member 2310 distally. The helical drive thread2710 interacts with the teeth 2450 of the upper vertebra members 2420 ina similar manner.

A power screw is a threaded rod with a full three hundred sixty degreenut around it. Rotation of the power screw causes the nut to advance ormove longitudinally. In the present arrangements, however, due to spaceconstraints, a full three hundred sixty degree nut cannot fit inside theend effector. In a general sense, the upper flexible spine assembly 2400and the lower flexible spine assembly 2500 comprise aradially/longitudinally segmented “power screw nut” that is rotatablydriven by the rotary drive screw 2700. When the rotary drive screw isrotated in a first rotary direction, the rotary drive screw 2700 drivesone or more vertebra members in each of the upper series and lowerseries of vertebra members longitudinally while the vertebra members2420, 2520 stay in the same locations radially. The upper series 2410and lower series 2510 are constrained from rotating around the rotarydrive screw 2700 and can only move longitudinally. In one arrangement,the upper vertebra members 2420 in the upper series 2410 and the lowervertebra members 2520 in the lower series 2510 only surround the rotarydrive screw 2700 with less than ten degrees each.

FIG. 25 illustrates the firing member 2310 in the home or startingposition. As can be seen in FIG. 25 , a portion of the helical drivethread 2710 on the rotary drive screw 2700 is engaged between the distalupper firing member tooth segment 2330 and the proximal upper firingmember tooth 2336 and another portion of the helical drive thread 2710is engaged between the distal lower firing member tooth 2360 and aproximal lower firing member tooth 2366 on the firing member 2310. Sucharrangement enables the rotary drive screw 2700 to precisely control thedistal and proximal movement of the firing member 2310 which, as will bediscussed in further detail below, can result in the precise movement ofthe anvil 1210. Once the firing member 2310 has been sufficientlydistally advanced during a firing stroke, the helical drive thread 2710operably engages the teeth on the upper and lower vertebras. See FIG. 26.

The surgical instrument 10 also comprises an articulation system 2240that is configured to apply articulation motions to the surgical endeffector 1000 to articulate the surgical end effector relative to theelongate shaft assembly 2000. In at least one arrangement, for example,the articulation system comprises four articulation cables 2242, 2246,2250, and 2254 that extend through the elongate shaft assembly 2000. SeeFIG. 27 . In the illustrated arrangement, the articulation cables 2242,2246 pass through the proximal mounting bushing 2750, the proximal end2214 of the elastomeric joint assembly 2210, as well as a central ribsegment 2216 to be secured to the distal end 2212 of the elastomericjoint assembly 2210 or other portion of the surgical instrument.Likewise, the articulation cables 2250 and 2254 extend through theproximal mounting bushing 2750, the proximal end 2214 of the elastomericjoint assembly 2210, as well as a central rib segment 2218 to be securedto the distal end 2212 of the elastomeric joint assembly 2210 or otherportion of the surgical end effector. The cables 2242, 2246, 2250, and2254 operably interface with an articulation control system that issupported in the housing of the surgical instrument 10. For example, aproximal portion of each cable 2242, 2246, 2250, and 2254 may be spooledon a corresponding rotary spool or cable-management system 2007 (FIG. 2) in the housing portion of the surgical instrument 10 that isconfigured to payout and retract each cable 2242, 2246, 2250, and 2254in desired manners. The spools/cable management system may be motorpowered or manually powered (ratchet arrangement, etc.). FIG. 29illustrates articulation of the surgical end effector 1000 through afirst articulation plane relative to the elongate shaft assembly 2000.FIG. 30 illustrates articulation of the surgical end effector 1000through a second articulation plane relative to the elongate shaftassembly 2000. FIG. 31 illustrates articulation of the surgical endeffector 1000 through multiple articulation planes relative to theelongate shaft assembly 2000.

FIGS. 32-34 illustrate an alternative articulation joint 2200′ in theform of an elastomeric joint assembly 2210′. As can be seen in FIG. 33 ,each articulation cable passes through a corresponding spring 2215′ thatis mounted in the ribs 2216′ of the elastomeric joint assembly 2210′.For example, cable 2242 extends through spring 2244. Cable 2246 extendsthrough spring 2248. Cable 2250 extends through spring 2252 and cable2254 extends through spring 2256. As indicated above, the end effectoris articulated by pulling on and relaxing the appropriate cables 2242,2246, 2250 and 2254. To achieve higher articulation angles with greaterjoint stability, each of the springs 2244, 2248, 2252, and 2256 canslide through the ribs of the elastomeric joint to push the end effectorand pull on the cables extending therethrough. The springs 2244, 2248,2252, and 2256 will also retract into the ribs when the cables 2242,2246, 2250, and 2254 are pulled tight. Each of the springs 2244, 2248,2252, and 2256 loosely seat over the particular cable that passestherethrough. Each cable and corresponding spring may terminate orotherwise be coupled to a corresponding solid rod that is supported inthe elongate shaft assembly 2000 and may be pushed and pulled from itsproximal end. When the cable is pulled, the corresponding spring wouldcarry little to no load. When the spring is pushed, the cable wouldcarry little load, but will help limit the end effector movement. Thisinteraction between the cable and spring may facilitate higherarticulation angles that may approach ninety degrees, for example.

Because the radially/longitudinally segmented power screw nutarrangement disclosed herein does not have the same constraints as athree hundred sixty degree nut, the upper vertebra members 2420 in theupper series 2410 and the lower vertebra members 2520 in the lowerseries 2510 are constrained to ensure that their loads are transferredto the firing member in a longitudinal direction. To maintain each ofthe upper vertebra members 2420 in the desired orientation and toprevent the upper vertebra members 2420 from becoming snagged ordisoriented when traversing through the articulation joint 2200, theupper vertebra members 2420 are aligned to pass through an upper sleeve2470 that extends through an upper portion of the outer elastomericjoint assembly 2210 of the articulation joint 2200. See FIGS. 27, 28,and 35 . A distal end 2472 of the upper sleeve 2470 is supported in theproximal end 1112 of the elongate channel 1110 and a proximal end 2474of the upper sleeve 2470 is supported in the distal end of the proximalsupport shaft 2120. The upper sleeve 2470 is fabricated from a polymeror plastic material that has a low coefficient of friction and isflexible to enable the upper sleeve 2470 to flex with the outerelastomeric joint assembly 2210. The upper sleeve 2470 protects theupper vertebra members 2420 from contacting the outer elastomeric jointassembly 2210 that is fabricated from an elastomeric material that mayhave a higher coefficient of friction than the coefficient of frictionof the material of the upper sleeve 2470. Stated another way, the uppersleeve 2470 forms a low friction, flexible, continuous, uninterrupted,and fully encapsulating path for the upper vertebra members 2420 as theytraverse the articulation joint 2200.

Similarly, a lower sleeve 2570 is employed to support the lower vertebramembers 2520 as they pass through the articulation joint 2200. A distalend 2572 of the lower sleeve 2570 is supported in the proximal end ofthe elongate channel and a proximal end of the lower sleeve 2570 issupported in the distal end of the proximal support shaft 2120. Like theupper sleeve 2470, the lower sleeve 2570 is fabricated from a polymer orplastic material that has a low coefficient of friction and is flexibleto enable the lower sleeve 2570 to flex with the outer elastomeric jointassembly 2210. The lower sleeve 2570 protects the lower vertebra members2520 from contacting the outer elastomeric joint assembly 2210 as theypass through the articulation joint 2200. Stated another way, the lowersleeve 2570 forms a low friction, flexible, continuous, uninterrupted,and fully encapsulating path for the lower vertebra members 2520 as theytraverse the articulation joint 2200. In various embodiments, the uppersleeve 2470 and the lower sleeve 2570 are configured to bend freelywithout creating a kink. To prevent the formation of kinks in thesleeves, in at least one arrangement, the sleeves 2470, 2570 aresupported within the outer elastomeric joint assembly 2210 such that thesleeves may move axially. For example, when the articulation jointangles up, the lower sleeve 2570 may slide distally and have a largebend radius; the upper sleeve 2470 in the same example, may slideproximally and have a tighter bend radius. By moving axially, the amountof material exposed outside of the joint assembly 2210 which mightotherwise be susceptible to kinking under a tight bend radius isreduced. In at least one arrangement, the distal end 2472 of the uppersleeve 2470 is formed with an upper scoop 2476 that is configured tofunnel the upper vertebra members 2420 into the anvil cap 1260.Similarly, the distal end of the lower sleeve 2570 may be formed with alower scoop that is configured to funnel the lower vertebra members 2520into the channel slot 1140 in the elongate channel 1110.

As indicated above, the anvil mounting portion 1230 comprises a pair oflaterally extending mounting pins 1232 that are configured to bereceived in corresponding mounting cradles or pivot cradles 1120 thatare formed in the proximal end 1112 of the elongate channel 1110. Themounting pins 1232 are pivotally retained within the mounting cradles1120 by an anvil cap 1260 that is attached to the proximal end 1112 ofthe elongate channel 1110 in the above-described manners. The anvil cap1260 comprises a proximal end 1262 and a distal end 1264 and has akeyhole-shaped vertebra passage 1266 extending therethrough toaccommodate passage of the top firing member feature 2320 and uppervertebra members 2420 therethrough. FIG. 36 illustrates the vertebrapassage 1266 in the anvil cap 1260. When the rotary drive screw 2700applies load to the upper vertebra members 2420, the vertebra members2420 will tend to tilt about the area A in FIG. 37 , so the uppervertebra member tooth 2450 is no longer square with the rotary drivescrew 2700 and may instead experience a higher-pressure line contact.Areas B in FIG. 37 show where the upper vertebra member 2420 stopstilting. To ensure that most of the loads stay in the longitudinaldirection to perform useful work, the upper vertebra member tooth 2450must be angled the same amount as the upper vertebra member 2420 tilts.Thus, when the upper vertebra member 2420 tilts, the upper vertebramember tooth 2450 will still maintain surface contact with the helicaldrive member 2710 on the rotary drive screw 2700 and all loads will bedirected longitudinally and not vertically. The slightly angled uppervertebra member tooth 2450 may behave like a square thread when thevertebra member 2420 is tilted and better distributes loads to lower thepressure contact. By directing most of the loads in the longitudinaldirection, vertical loads are avoided which could result in theestablishment of friction that would counter the longitudinal loads. Theupper vertebra members 2420 react similarly as they pass down thekeyhole-shaped anvil slot 1240. Likewise, the lower vertebra members2520 react similarly as they pass through the keyhole-shaped axiallyextending channel slot 1140 in the elongate channel 1110.

In the illustrated arrangement, the anvil 1210 is moved to the openposition by a pair of anvil springs 1270 that are supported within theproximal end of the elongate channel. See FIGS. 38, 42, and 43 . Thesprings 1270 are positioned to apply a pivotal biasing force tocorresponding anvil control arms 1234 that may be integrally formed withanvil mounting portion 1230 and extend downwardly therefrom. See FIG. 38.

FIGS. 39-41 illustrate portions of the anvil 1210, the firing member2310, and the anvil cap 1260 when the anvil 1210 is open (FIG. 39 ),when the anvil 1210 is partially closed (FIG. 40 ) and after the firingmember has been advanced distally from the home or starting position(FIG. 41 ). As can be seen in FIG. 39 , when the firing member 2310 isin the home or starting position, the top firing member feature 2320 iscompletely received within the vertebra passage 1266 in the anvil cap1260. During a firing stroke, the top firing member feature 2320 and theupper vertebra members 2420 in the upper series 2410 must transitionfrom the vertebra passage 1266 in the anvil cap 1260 to thekeyhole-shaped anvil slot 1240. Thus, it is desirable to minimize anygap “G” between the anvil mounting portion 1230 and a distal end 1264 ofthe anvil cap 1260. To minimize this gap G while facilitate unimpededpivotal travel of the anvil 1210, the distal end 1264 of the anvil cap1260 is formed with a curved cap surface 1265 that matches a curvedmating surface 1231 on the anvil mounting portion 1230. Both surfaces1265, 1231 are curved and concentric about the pivot axis PA or someother reference point. Such arrangement allows the anvil 1210 to moveradially and not interfere with the anvil cap 1260 while maintaining aminimal gap G therebetween. The gap G between the anvil mounting portion1230 and the distal end 1264 of the anvil cap 1260 is significantlyshorter than a length of an upper vertebra member 2420 which facilitateseasy transition of each upper vertebra member 2420 from the vertebrapassage 1266 in the anvil cap 1260 to the keyhole-shaped anvil slot1240. In addition, to further assist with the transition of the topfiring member feature 2320 into the keyhole-shaped anvil slot 1240, aramped surface 1241 is formed adjacent the curved mating surface 1231 onthe anvil mounting portion 1230. As the firing member 2310 is initiallyadvanced distally from the home or starting position, a distal end ofthe top firing member feature 2320 contacts the ramped surface 1241 andbegins to apply a closing motion to the anvil 1210 as can be seen inFIG. 40 . Further distal advancement of the firing member 2310 duringthe firing stroke or firing sequence causes the top firing memberfeature to enter the keyhole shaped anvil slot 1240 to completely closethe anvil 1210 and retain the anvil 1210 in the closed position duringthe firing sequence. See FIG. 41 .

In general, the highest firing forces established in an endocutter areassociated with cutting and stapling tissue. If those same forces can beused to close the anvil, then the forces generated during pre-clampingand grasping of tissue can be high as well. In at least one arrangement,the firing member body 2312 further comprises a firing member wing ortab 2355 that extends laterally from each lateral side of the firingmember body 2312. See FIGS. 15 and 36 . The firing member wings 2355 arepositioned to contact the corresponding anvil control arms 1234 when thefiring member 2310 is driven in the proximal direction PD from the homeor starting position to quickly close the anvil 1210 for graspingpurposes. In at least one arrangement, when the firing member 2310 is inthe home or starting position, the firing member wings 2355 are locateddistal to the anvil control arms 1234 as shown in FIG. 42 . When thefiring member 3210 is moved proximally, the firing member wings 2355push the anvil control arms 1234 (pivotal direction C) against the biasof the anvil springs 1270. See FIG. 42 . In one arrangement, the firingmember 2310 only has to move a short distance D to pivot the anvil 1210to a closed position. In one embodiment, distance D may be approximately0.070 inches long, for example. This short movement allows for a quickresponse. Because the anvil pivot point or pivot axis PA is relativelyfar from the firing member wings 2355 which creates a substantial momentarm, the proximal movement of the firing member 2310 (and firing memberwings 2355) results in an application of high pre-compression torque tothe anvil 1210 to move the anvil 1210 to a closed position. Thus, thefiring member wings 2355 may be referred to herein as “pre-compressionfeatures”. See FIG. 43 . Thus, the clinician may use the surgical endeffector 1000 to grasp and manipulate tissue between the anvil 1210 andthe surgical staple cartridge 1300 without cutting the tissue andforming the staples, by advancing the firing member 2310 proximally theshort distance D to cause the anvil 1210 to quickly pivot to a closedposition.

The firing member 2310 may be moved in the proximal direction PD byrotating the rotary drive screw 2700 in a second rotary direction. Thus,when the firing member 2310 is in the “home” or starting position, theanvil 1210 may be biased into the fully open position by the anvilsprings 1270. Activation of the rotary drive system 2600 to apply arotary motion to the rotary drive screw 2700 in a first rotary directionwill cause the firing member 2310 to be advanced distally from the homeor starting position to apply an anvil closure motion to the anvil 1210to move the anvil closed to clamp the target tissue between the anvil1210 and the surgical staple cartridge 1300. Continued rotation of therotary drive screw in the first rotary direction will cause the firingmember 2310 to continue to distally advance through the surgical endeffector 1000. As the firing member 2310 moves distally, the firingmember 2310 contacts a sled 1312 (FIG. 19 ) that is supported in thesurgical staple cartridge 1300 and drives the sled 1312 distally throughthe staple cartridge body 1302. When the firing member 2310 is in thehome or starting position, the surgeon may wish to use the surgical endeffector to grasp and manipulate tissue. To do so, the rotary drivesystem is actuated to apply a second rotary drive motion to the rotarydrive screw 2700 in a second rotary direction that is opposite to thefirst rotary direction. Such rotary movement of the rotary drive screw2700 in the second rotary direction will drive the firing member 2310proximally from the starting position and cause the anvil 1210 toquickly pivot to the closed position. Thus, in accordance with at leastone embodiment, the “home or starting position” of the firing member2310 is not its proximal-most position.

If during the firing process, the rotary drive system 2600 quitsrotating, the firing member 2310 may become stuck within the surgicalend effector. In such instance, the top firing member feature 2320 mayremain engaged with the anvil 1210 and the bottom firing member feature2350 may remain engaged with the elongate channel 1110 and therebyprevent the surgeon from moving the anvil 1210 to an open position torelease the tissue clamped between anvil 1210 and surgical staplecartridge 1300. This could occur, for example, if the motor or othercontrol arrangement supplying the rotary drive motions to the rotarydrive shaft 2610 fails or otherwise becomes inoperative. In suchinstances, the firing member 2310 may be retracted back to the home orstarting position within the surgical end effector 1000 by pulling thetop cable 2404 and the lower cable 2504 in a proximal direction. Forexample, a proximal portion of the top cable 2404 and a proximal portionof the lower cable 2505 may be spooled on a rotary spool orcable-management system 2009 (FIG. 2 ) in the housing portion of thesurgical instrument 10 that is configured to payout the top cable 2404and lower cable 2504 during the firing stroke and also retract thecables 2404, 2504 in a proximal direction should the firing member 2310need to be retracted. The cable management system 2009 may be motorpowered or manually powered (ratchet arrangement, etc.) to applyretraction motions to the cables 2404, 2504. When the cables 2404, 2504are retracted, the upper vertebra members 2420 and lower vertebramembers 2520 will cause the rotary drive screw 2700 to spin in reverse.

The following equation may be used to determine whether the rotary drivescrew 2700 will spin in reverse depending upon the lead (L), pitchdiameter (d_(p)), tooth angle (α) and friction (μ):

$\mu \geq {\frac{L}{\pi d_{p}}\cos\;\alpha}$

The rotary drive screw 2700 may self-lock if the above equation is true.For the most part, in many instances, the pitch diameter is mostly fixedfor an endocutter, but the lead and tooth angle are variable. Becausethe upper vertebra member teeth 2450 and lower vertebra member teeth2550 are mostly square, the rotary drive screw 2700 is more likely to beback drivable (cos (90)=1). The leads of the upper vertebra member teeth2450 and lower vertebra member teeth 2550 may also be advantageous inthat the rolling friction between the vertebra members 2420, 2520 andthe rotary drive screw 2700 is more likely to enable the rotary drivescrew 2700 to be back driven. Thus, in the event of an emergency, thesurgeon can pull on the upper and lower cables 2404, 2504 in theproximal direction to cause the firing member 2310 to fully retract fora quick “bailout”.

As indicated above, the relative control motions for the rotary drivesystem 2600, as well as the various cable-management systems employed inconnection with the firing system 2300 and the articulation controlsystem 2240, may be supported within a housing 2002 which may behandheld or comprise a portion of a larger automated surgical system.The firing system 2300, articulation control system 2240, and the rotarydrive system 2600 may, for example, be motor-controlled and operated byone or more control circuits.

One method of using the surgical instrument 10 may involve the use ofthe surgical instrument 10 to cut and staple target tissue within apatient using laparoscopic techniques. For example, one or more trocarsmay have been placed through the abdominal wall of a patient to provideaccess to a target tissue within the patient. The surgical end effector1000 may be inserted through one trocar and one or more cameras or othersurgical instruments may be inserted through the other trocar(s). Toenable the surgical end effector 1000 to pass through the trocarcannula, the surgical end effector 1000 is positioned in anunarticulated orientation and the jaws 1100 and 1200 must be closed. Toretain the jaws 1100 and 1200 in the closed position for insertionpurposes, for example, the rotary drive system 2600 may be actuated toapply the second rotary motion to the rotary drive screw 2700 to causethe firing member 2310 to move proximally from the starting position tomove the anvil 1210 (jaw 1200) to the closed position. See FIG. 44 . Therotary drive system 2600 is deactivated to retain the firing member 2310in that position. Once the surgical end effector has passed into theabdomen through the trocar, the rotary drive system 2600 may beactivated to cause the rotary drive screw 2700 to drive the firingmember 2310 distally back to the starting position wherein the anvilsprings 1270 will pivot the anvil 1210 to the open position. See FIG. 38.

Once inside the abdomen and before engaging the target tissue, thesurgeon may need to articulate the surgical end effector 1000 into anadvantageous position. The articulation control system 2240 is thenactuated to articulate the surgical end effector in one or more planesrelative to a portion of the elongate shaft assembly 2000 that isreceived within the cannula of the trocar. Once the surgeon has orientedthe surgical end effector 1000 in a desirable position, the articulationcontrol system 2240 is deactivated to retain the surgical end effector1000 in the articulated orientation. The surgeon may then use thesurgical end effector to grasp the target tissue or adjacent tissue byactivating the rotary drive system to rotate the rotary drive screw inthe second rotary direction to move the firing member proximally tocause the anvil 1210 to rapidly close to grasp the tissue between theanvil 1210 and the surgical staple cartridge 1300. The anvil 1210 may beopened by reversing the rotation of the rotary drive screw 2700. Thisprocess may be repeated as necessary until the target tissue has beproperly positioned between the anvil 1210 and the surgical staplecartridge 1300.

Once the target tissue has been positioned between the anvil 1210 andthe surgical staple cartridge, the surgeon may commence the closing andfiring process by activating the rotary drive system 2600 to drive thefiring member 2310 distally from the starting position. As the firingmember 2310 moves distally from the starting position, the firing member2310 applies a closure motion to the anvil 1210 and moves the anvil 1210from the open position to the closed position in the manners discussedabove. As the firing member 2310 moves distally, the firing member 2310retains the anvil 1210 in the closed position thereby clamping thetarget tissue between the anvil 1210 and the surgical staple cartridge1300. As the firing member 2310 moves distally, the firing member 2310contacts a sled 1312 supported in the surgical staple cartridge 1300 andalso drives the sled 1312 distally through the staple cartridge body1302. The sled 1312 serially drives rows of drivers supported in thestaple cartridge toward the clamped target tissue. Each driver hassupported thereon one or more surgical staples or fasteners which arethen driven through the target tissue and into forming contact with theunderside of the anvil 1210. As the firing member 2310 moves distally,the tissue cutting edge 2314 thereon cuts through the stapled tissue.

After the firing member 2310 has been driven distally to the endingposition within the surgical end effector 1000 (FIG. 45 ), the rotarydrive system 2600 is reversed which causes the firing member 2310 toretract proximally back to the home or starting position. Once thefiring member 2310 has returned to the starting position, the anvilsprings 1270 will pivot the anvil 1210 to the open position to enablethe surgeon to release the stapled tissue from the surgical end effector1000. Once the stapled tissue has been released, the surgical endeffector may be withdrawn out of the patient through the trocar cannula.To do so, the surgeon must first actuate the articulation control system2240 to return the surgical end effector 1000 to an unarticulatedposition and actuate the rotary drive system to drive the firing member2310 proximally from the home or starting position to close the jaws.Thereafter, the surgical end effector 1000 may be withdrawn through thetrocar cannula. If during the firing process or during the retractionprocess, the firing system becomes inoperative, the surgeon may retractthe firing member 2310 back to the starting position by applying apulling motion to the cables 2404, 2505 in the proximal direction in thevarious manners described herein.

FIGS. 46-48 illustrate another form of articulation joint 18200 thatcomprises a proximal joint member 18210 and a distal joint member 18250.The proximal joint member 18210 is configured to be attached to a distalend of an elongate shaft assembly 18100 (FIG. 47 ) that is coupled to ahousing or other portion of a surgical instrument in the various mannersdisclosed herein. The distal joint member 18250 may be attached to aclosure tube arrangement 18110 (FIG. 47 ) that is configured to applyclosing and/or opening motions to a movable jaw of an end effector18000. In alternative arrangements, the distal joint member 18250 may beattached to one of the end effector jaws or other mounting portion ofthe end effector 18000. For example, the distal joint member 18250 maybe attached to an elongate channel of an endo-cutter arrangement in thevarious manners disclosed herein. In at least one arrangement, forexample, the shaft assembly 18100 defines a shaft axis SA and the endeffector 18000 defines and end effector axis EA. The articulation jointfacilitates selective articulation of the end effector 18000 relative tothe shaft assembly 18100 in an articulation plane between anunarticulated position wherein the end effector axis EA is axiallyaligned with the shaft axis SA and articulated positions wherein the endeffector axis EA is not aligned with the shaft axis SA.

As can be seen in FIGS. 46-48 , the proximal joint member 18210comprises a proximal mounting hub 18212. The proximal mounting hub, forexample, may be configured to be inserted into a hollow outer shaft ortube portion 18102 of an elongate shaft assembly 18100 and be attachedthereto by welding, adhesive, etc. The illustrated example furthercomprises a distally-facing collar portion 18214 that defines adistally-facing mounting area, generally designated as 18220. See FIG.48 . To accommodate passage of various control shafts/drive membersthrough the articulation joint 18200, the proximal joint member 18210further comprises a proximal central passage 18216 that extends throughthe proximal mounting hub 18212 into the distally-facing mounting area18220. In the illustrated example, the proximal central passage 18216 isconfigured to accommodate a proximal drive shaft 18310 that is a portionof a rotary drive system 18300. In other arrangements, a flexible driveshaft (not shown) may extend through the proximal central passage 18216.

The distal joint member 18250 comprises a distal mounting hub 18252 thatis configured to be inserted into a hollow outer shaft 18114 or closuretube or mounting hub of a surgical end effector 18000 and be attachedthereto by welding, adhesive, etc. The surgical end effector 18000 maycomprise any of the surgical end effector examples disclosed herein. Theillustrated example further comprises a proximally-facing collar portion18254 that defines a proximally-facing mounting area, generallydesignated as 18260. In addition, the distal joint member 18250 furthercomprises a distal central passage 18256 that extends from thedistally-facing mounting area 18220 through the distal mounting hub18252. In the illustrated example, the distal central passage 18256 isconfigured to accommodate a distal drive shaft 18330 that is a portionof the rotary drive system 18300 or in other embodiments, the distalcentral passage 18256 may support another portion of a flexible driveshaft arrangement.

The illustrated example further comprises an articulation linkageassembly 19000 that extends between the proximal joint member 18210 andthe distal joint member 18250 and is configured to operably interfacetherewith to facilitate articulation of the distal joint member 18250(and the surgical end effector coupled thereto) relative to proximaljoint member 18210 (and the elongate shaft assembly 18100 coupledthereto). As can be seen in FIG. 48 , the articulation linkage assembly19000 comprises a first link 19010, a second link 19030, and a thirdlink 19050. Each of the links 19010, 19030 and 19050 is movably capturedbetween the proximal joint member 18210 and the distal joint member18250, but, as will be discussed in further detail below, none of thelinks 19010, 19030, 19050 are directly attached to either of theproximal joint member 18210 and the distal joint member 18250.

In one example, the first link 19010 comprises a rigid first link body19012 that defines a first proximal end 19014 and a first distal end19018. The first proximal end 19104 has a first proximal saddle 19016formed therein that is configured to be pivotally received on acorresponding first proximal mounting lug 18222 formed in thedistally-facing mounting area 18220. The first proximal mounting lug18222 has an arcuate proximal pivot surface 18223 thereon and defines afirst proximal pivot axis FPPA. See FIG. 49 . The first proximal saddle19016 comprises a U-shaped proximal pivot surface 19017 that isconfigured to rollably or movably interface with the arcuate proximalpivot surface 18223 on the first proximal mounting lug 18222 such thatthe first link 19010 is movable relative to proximal joint member 18210about the first proximal pivot axis FPPA in multiple directions or inmultiple proximal travel paths. For example, the first proximal saddle19016 can move relative to the first proximal pivot axis FPPA in a firstproximal travel path FPTP and a second proximal travel path SPTP. In atleast one arrangement, the first proximal travel path FPTP is transverseto the second proximal travel path SPTP. See FIGS. 49 and 51-54 .

The first distal end 19108 comprises a first distal saddle 19020 formedtherein that is configured to be pivotally received on a correspondingfirst distal mounting lug 18262 formed in the proximally-facing mountingarea 18260. The first distal mounting lug 18262 has an arcuate pivotsurface 18263 and defines a first distal pivot axis FDPA. See FIG. 50 .The first distal saddle 19020 comprises a U-shaped pivot surface 19022that is configured to rollably or movably interface with the arcuatepivot surface 18263 on the first distal mounting lug 18262 such that thefirst link 19010 is movable relative to the distal proximal joint member18250 about the first distal pivot axis FDPA in multiple directions ormultiple distal travel paths. For example, the first distal saddle 19020can move relative to the first distal pivot axis FDPA in a first distaltravel path FDTP and a second distal travel path SDTP. In at least onearrangement, the first distal travel path FDTP is transverse to thesecond distal travel path SDTP. See FIG. 50 .

The second link 19030 comprises a rigid second link body 19032 thatdefines a second proximal end 19034 and a second distal end 19038. Thesecond proximal end 19034 has a second proximal saddle 19036 formedtherein that is configured to be pivotally received on a correspondingsecond proximal mounting lug 18224 formed in the distally-facingmounting area 18220. The second proximal mounting lug 18224 has a secondarcuate proximal pivot surface 18225 thereon and defines a secondproximal pivot axis SPPA. See FIG. 49 . The second proximal saddle 19036comprises a second U-shaped proximal pivot surface 19037 that isconfigured to rollably or movably interface with the second arcuateproximal pivot surface 18225 on the second proximal mounting lug 18224such that the second link 19030 is movable relative to proximal jointmember 18210 about the second proximal pivot axis SPPA in multipledirections or multiple proximal travel paths. For example, the secondproximal saddle 19036 can move relative to the second proximal pivotaxis SPPA in a first proximal travel path FPTP and a second proximaltravel path SPTP. In at least one arrangement, the first proximal travelpath FPTP is transverse to the second proximal travel path SPTP. SeeFIG. 49 .

The second distal end 19038 comprises a second distal saddle 19040 thatis configured to be pivotally received on a corresponding second distalmounting lug 18264 formed in the proximally-facing mounting area 18260.See FIG. 50 . The second distal mounting lug 18264 has a second arcuatedistal pivot surface 18265 and defines a second distal pivot axis SDPA.The second distal saddle 19040 comprises a second U-shaped distal pivotsurface 19042 that is configured to rollably interface with the secondarcuate distal pivot surface 18265 on the second distal mounting lug18264 such that the second link 19030 is movable relative to the distaljoint member 18250 about the second distal pivot axis SDPA in multipledirections or multiple distal paths. For example, the second distalsaddle 19040 can move relative to the second distal pivot axis SDPA in afirst distal travel path FDTP and a second distal travel path SDTP. Inat least one arrangement, the first distal travel path FDTP istransverse to the second distal travel path SDTP. See FIG. 50 .

The third link 19050 comprises a rigid third link body 19052 thatdefines a third proximal end 19054 and a third distal end 19058. Thethird proximal end 19054 has a third proximal saddle 19056 formedtherein that is configured to be pivotally received on a correspondingthird proximal mounting lug 18226 formed in the distally-facing mountingarea 18220. The third proximal mounting lug 18226 has a third arcuateproximal pivot surface 18227 and defines a third proximal pivot axisTPPA. See FIG. 49 . The third proximal saddle 19056 comprises a thirdU-shaped proximal pivot surface 19057 that is configured to rollably ormovably interface with the third arcuate proximal pivot surface 18227 onthe third proximal mounting lug 18226 such that the third link 19050 ismovable relative to proximal joint member 18210 about the third proximalpivot axis TPPA in multiple directions or multiple travel paths. Forexample, the third proximal saddle 19056 can move relative to the thirdproximal pivot axis TPPA in a first proximal travel path FPTP and asecond proximal travel path SPTP. In at least one arrangement, the firstproximal travel path FPTP is transverse to the second proximal travelpath SPTP. See FIG. 49 .

The third distal end 19058 comprises a third distal saddle 19060 that isconfigured to be pivotally received on a corresponding third distalmounting lug 18266 formed in the proximally-facing mounting area 18260.See FIG. 50 . The third distal mounting lug 18266 comprises a thirdarcuate distal pivot surface 18267 and defines a third distal pivot axisTDPA. The third distal saddle 19060 comprises a third U-shaped distalpivot surface 19062 that is configured to rollably or movably interfacewith the third arcuate distal pivot surface 18267 on the third distalmounting lug 18266 such that the third link 19050 is movable relative tothe distal joint member 18250 about the third distal pivot axis TDPA inmultiple directions or multiple distal travel paths. For example, thethird distal saddle 19060 can move relative to the third distal pivotaxis TDPA in a first distal travel path FDTP and a second distal travelpath SDTP. In at least one arrangement, the first distal travel pathFDTP is transverse to the second distal travel path SDTP. See FIG. 50 .

In the illustrated arrangement, none of the links 19010, 19030, and19050 are directly attached to either of the proximal joint member 18210or the distal joint member 18250. Instead, the link assembly 19000 issupported in movable pivotal engagement with the proximal joint member18210 and the distal joint member 18250 by a cable-based articulationsystem 18400. In the illustrated example, the articulation joint 18200is operably controlled by a cable control system 18400 that comprisesfour flexible actuator members in the form of cables 18410, 18420,18430, and 18440 that extend through the elongate shaft assembly tooperably interface with a cable control system that may be supportedwithin the housing of the surgical instrument. The cable control systemmay comprise a plurality of cable support members/capstans, pulleys,etc. that are controlled by one or more corresponding motors that arecontrolled by a control circuit portion of the surgical instrument. Thecable control system is configured to manage the tensioning (pulling)and paying out of cables at precise times during the articulationprocess. As can be seen in FIG. 46 , the cable 18410 extends through acorresponding passage 18412 in the proximal joint member 18210 into acorresponding passage 18414 in the distal joint member 18250 and has aretainer lug (not shown) thereon to prevent it from pulling through thedistal joint member 18250. The cable 18420 extends through acorresponding passage 18422 in the proximal joint member 18210 andenters a corresponding passage in the distal joint member 18250 and hasa retainer lug (not shown) thereon to prevent it from pulling throughthe distal joint member 18250. The cable 18430 extends through acorresponding passage 18432 in the proximal joint member 18210 into acorresponding passage 18434 in the distal joint member 18250 and has aretainer lug (not shown) thereon to prevent it from pulling through thedistal joint member 18250. The cable 18440 extends through acorresponding passage 18442 in the proximal joint member 18210 into acorresponding passage 18444 in the distal joint member 18250 and has aretainer lug (not shown) thereon to prevent it from pulling through thedistal joint member 18250. Thus, in one sense, the cables 18410, 18420,18430, and 18440 span the articulation joint 18200 to apply articulationmotions to the distal joint member 18250.

The distal joint member 18250 is selectively articulatable in multipledirections relative to the proximal joint member 18210 by applyingtension to the various cables while enabling the remaining cables toslacken. As can be seen in FIGS. 55 and 56 , the link assembly 19000facilitates articulation motions that essentially approximate a distalvirtual sphere VDS that rolls relative to a virtual proximal sphere VPS.In the illustrated arrangement, the rotary drive system 18300 furthercomprises a central “dog bone” drive shaft 18320 that has a sphericalproximal end 18322 that is received in a proximal socket 18312 in theproximal drive shaft 18310 and is movably retained therein bycorresponding pins 18324. The central drive shaft 18320 further has aspherical distal end 18326 that is received within a distal socket 18332in the distal drive shaft 18330 and is movably retained therein bycorresponding pins 18328. Other flexible drive shaft arrangements(rotary and/or non-rotary) may also be employed. As can also be seen inFIG. 55 , the three links 19010, 19030, and 19050 are configured with ageometry that places the distal end of each link at 180 degrees (aboutthe longitudinal axis) from the proximal end of the link. Eachrespective link 19010, 19030, and 19050 “reaches around” the centraldrive shaft 18320. Stated another way, the first link 19010 defines afirst link axis FLA. The second link 19030 defines a second link axisSLA and the third link 19050 defines a third link axis TLA. In onearrangement, the links 19010, 19030, and 19050 are supported relative toeach other such that the first link axis FLA, the second link axis SLA,and the third think axis TLA are transverse to each other. See FIG. 48 .The specific geometric location of the lugs and saddle arrangementsdefine a linkage 19000 that moves the distal joint member 18250 relativeto the proximal joint member 18210 as if it was a ball rolling onanother ball. The cables hold the links in compression so that thesaddles are retained in movable engagement with their corresponding lugsin the proximal joint member 18210 and the distal joint member 18250without being otherwise directly coupled thereto (e.g., without pins orother arrangements).

Closing an anvil requires a system that meets many requirements. Theclosure system needs to respond fast to the hand motions of the surgeonwho is either operating the robotic system or the hand held system towhich the end effector is attached. The closure system must also becapable of applying enough load on the tissue to ensure proper stapleformation. It should also be easy to bail out in the event of failurewhile closing. These features should all be attainable within afootprint that is as small as possible to ensure adequatemaneuverability within the patient.

FIGS. 57-59 illustrate a surgical end effector 20000 that comprises aclosure system 20400 that may address many if not all of the foregoingchallenges. In the illustrated example, the surgical end effector 20000comprises an elongate channel 20100 that is configured to operablysupport a surgical staple cartridge 20300 therein. The surgical endeffector 20000 further comprises an anvil 20200 that is configured tomove between an open position and a closed position relative to thesurgical staple cartridge 20300 to clamp tissue therebetween. As can beseen in FIGS. 59 and 60 , the closure system 20400 comprises a rotarydriven closure cam member 20410 that is configured to apply closuremotions to the anvil 20200. In one arrangement, the closure cam member20410 is supported on a rotatable cam shaft 20420 that has a driven gear20422 formed thereon. The driven gear 20422 is supported in meshingengagement with a rotary closure gear 20660 that may be driven by amotor/gearbox arrangement supported in a housing of the surgicalinstrument to which the surgical end effector is operably attached. Ascan be seen in FIGS. 61 and 62 , the cam shaft 20420 comprises a spiraldrive groove 20424 that is configured to receive a drive pin 20412 onthe closure cam member 20410. Rotation of the cam shaft 20420 in a firstrotary direction will cause the closure cam member 20410 to move in thedistal direction DD from a starting position (FIGS. 59 and 61 ) to anending position (FIGS. 50 and 62 ).

In one arrangement, the anvil 20200 comprises an anvil mounting portion20210 that comprises two mounting arms 20212 that each have a slottherein that is configured to receive a corresponding pivot pin 20216that protrudes from a proximal end of the elongate channel 20100. SeeFIG. 58 . The closure cam member 20410 further comprises two closurecams 20414 that correspond to the anvil mounting arms 20212 of the anvil20200. In one arrangement, the anvil 20200 may be biased into the openposition shown in FIGS. 58 and 59 by a spring (not shown). The anvil20200 is moved to a closed position by actuating the rotary closure gear20660 to drive the closure cam member 20410 distally from the startingposition to the ending position. As the closure cam member 20410 isdriven distally, the closure cams 20414 contact the correspondingmounting arms 20212 and causes the anvil 20200 to pivot to the closedposition shown in FIG. 60 .

FIG. 63 illustrates the surgical end effector 20000 attached to anarticulation joint 20500 that employs a rotary drive assembly 20600 fortransmitting rotary drive motions across the articulation joint 20500.In the illustrated example, the rotary drive assembly 20600 comprisesnested universal joints that can permit the surgical end effector 20000to roll distal to the articulation joint 20500. A two-side jointarrangement wherein each joint can angle approximately seventy degrees(one hundred forty degrees total) may be employed, for example.

In one arrangement, the articulation joint 20500 comprises a proximaljoint member 20510 that may be attached to an outer tube member of anelongate shaft assembly that is coupled to or operably interfaces with ahousing of a surgical instrument. In alternative arrangements, theproximal joint member 20510 may be integrally formed on a distal end ofthe outer tube member of the elongate shaft. As can be seen in FIGS.63-65 , the proximal joint member 20510 comprises a distally protrudingupper pivot tang 20520 and a distally protruding lower pivot tang 20530.The articulation joint 20500 further comprises a distal joint member20540 that is attached to the surgical end effector 20000. In oneexample, the distal joint member 20540 is attached to the proximal endof the elongate channel 20100 and includes a proximally protruding upperpivot tang 20550 and a proximally protruding lower pivot tang 20560. Inthe illustrated example, the distally protruding upper pivot tang 20520is formed with a series of proximal articulation gear teeth 20522 andthe proximally protruding upper pivot tang 20550 is formed with a seriesof distal articulation gear teeth 20552. The distally protruding lowerpivot tang 20530 is formed with an arcuate proximal surface 20532 andthe proximally protruding lower pivot tang 20560 is formed with anarcuate distal surface 20562. In one example, the rotary drive assembly20600 extends through the articulation joint 20500 and serves to retainthe proximal articulation gear teeth 20522 in meshing engagement withthe distal articulation gear teeth 20552 to facilitate pivotal traveltherebetween. In addition, in at least one arrangement, the arcuatedistal surface 20562 and the arcuate proximal surface 20532 may besupported in rocking engagement with each other. Such arrangementpermits the surgical end effector 20000 to articulate through a singlearticulation plane relative to the elongate shaft assembly uponapplication of articulation control motions to the surgical end effector20000. Such articulation control motions may be applied to the surgicalend effector by cables or other articulation members (not shown) thatextend from control systems in the surgical instrument housing and spanthe articulation joint 20500 to operably interface with the surgical endeffector.

Turning to FIG. 65 , the rotary drive system 20600 comprises a series ofnested shaft systems 20610, 20710, and 20810. As can be seen in FIG. 65, the centermost “first” shaft system 20610 comprises a first proximalshaft member 20620 that is attached to or otherwise operably interfaceswith a corresponding first rotary drive system supported by the housingof the surgical instrument. For example, the first rotary drive systemmay comprise a corresponding motor/gear arrangement configured to rotatethe first proximal shaft member 20620. The first shaft system 20610further comprises a first central shaft 20630 that comprises a shaftbody 20632 that has a first spherical proximal end 20634 that isrotatably supported in a first spherical proximal cup 20622 on the firstproximal shaft member 20620. The first central shaft 20630 is movablypinned within a cavity 20624 in the first spherical proximal cup 20622by a first proximal pin 20636 that extends through an arcuate slot 20635in the first spherical proximal end 20634. The first central shaft 20630further comprises a first spherical distal end 20640 that is rotatablysupported in a first spherical distal cup 20652 that is attached to afirst distal shaft member 20650. The first central shaft 20630 ismovably pinned within a cavity 20654 in the first spherical distal cup20652 by a first distal pin 20644 that extends through an arcuate slot20642 in the first spherical distal end 20640. In one arrangement, forexample, the first distal shaft member 20650 may be configured to applyrotary motions to the closure gear 20660 to apply rotary closure motionsto the rotatable cam shaft 20420 in the manners described above. SeeFIGS. 59 and 60 , for example. Thus, in at least one arrangement,actuation of the first rotary drive system to cause rotation of thefirst proximal shaft member 20620 will result in actuation of theclosure system 20400 to move the anvil 20200 from an open position to aclosed position.

Referring to FIGS. 65-67 , the second shaft system 20710 comprises asecond proximal shaft member 20720 that is attached to or otherwiseoperably interfaces with a corresponding second rotary drive systemsupported by the housing of the surgical instrument. For example, thesecond rotary drive system may comprise a corresponding motor/geararrangement configured to rotate the second proximal shaft member 20720.The second shaft system 20710 further comprises a second hollow centralshaft 20730 that comprises a hollow shaft body 20732 that has a secondspherical proximal end 20734. In one arrangement, the second hollowcentral shaft 20730 may be fabricated in two segments that are welded orotherwise coupled together. The second spherical proximal end 20734defines a second central proximal cavity 20735 that is configured tomovably receive therein the first spherical proximal cup 20622 of thefirst proximal shaft member 20620 therein. The second spherical proximalend 20734 is configured to be rotatably supported in a second sphericalproximal cup 20722 on the second proximal shaft member 20720. The secondhollow central shaft 20730 is movably pinned within a cavity 20724 inthe second spherical proximal cup 20722 by second proximal pin segments20736 that extend from the second spherical proximal end 20734 to bemovably received within corresponding arcuate slots 20726 in the secondspherical proximal cup 20722 on the second proximal shaft member 20720.The second hollow central shaft 20730 further comprises a secondspherical distal end 20740. The second spherical distal end 20740defines a second central distal cavity 20742 that is configured tomovably receive therein the first spherical distal cup 20652 of thefirst distal shaft member 20650 therein. The second hollow central shaft20730 is movably pinned within a cavity 20754 in the second sphericaldistal cup 20752 by second distal pin segments 20746 that extend fromthe second spherical distal end 20740 to be movably received withincorresponding arcuate slots 20756 in the second spherical distal cup20752 on the second distal shaft member 20750.

In one arrangement, the second distal shaft member 20750 may beconfigured to apply rotary motions to a first rotary drive gear 20760that is in meshing engagement with a driven gear 20762 that is attachedto a rotary drive shaft 20770 that is rotatably supported in theelongate channel 20100. See FIGS. 59, 60, and 68 . As can be seen inFIGS. 59, 60, and 68 , the surgical end effector 20000 further comprisesa firing member 20310 that is in threaded engagement with the rotarydrive shaft 20770. Rotation of the rotary drive shaft 20770 in a firstrotary direction will cause the firing member 20310 to move distallyfrom a starting position (FIG. 59 ) through the surgical end effector20000 to an ending position. Rotation of the rotary drive shaft 20770 inan opposite rotary motion will drive the firing member 20310 from theending position back to the starting position. Thus, in at least onearrangement, actuation of the second rotary drive system to causerotation of the second proximal shaft member 20720 will result inactuation of the firing member 20310 to cut and staple tissue that isclamped between the anvil 20200 and the surgical staple cartridge 20300.

Referring to FIGS. 65-67 , the third shaft system 20810 comprises athird proximal shaft member 20820 that is attached to or otherwiseoperably interfaces with a corresponding third rotary drive systemsupported by the housing of the surgical instrument. For example, thethird rotary drive system may comprise a corresponding motor/geararrangement configured to rotate the third proximal shaft member 20820.The third shaft system 20810 further comprises a third hollow centralshaft 20830 that comprises a hollow shaft body 20832 that has a thirdspherical proximal end 20834. In one arrangement, the third hollowcentral shaft 20830 may be fabricated in two segments that are welded orotherwise coupled together. The third spherical proximal end 20834defines a third proximal cavity 20835 that is configured to movablyreceive therein the second spherical proximal cup 20722 of the secondproximal shaft member 20720 therein. The third spherical proximal end20834 is configured to be movably supported in a third proximal socket20824 in the third proximal shaft member 20820. The third sphericalproximal end 20834 is axially movable within the third proximal socket20824 and is attached thereto by third proximal pin segments 20836 thatextend from the third spherical proximal end 20834 to be movablyreceived within corresponding axial slots 20824 in the third proximalsocket 20824 on the third proximal shaft member 20820. The third centralshaft 20830 further comprises a third spherical distal end 20840. Thethird spherical distal end 20840 defines a third central distal cavity20842 that is configured to movably receive therein the second sphericaldistal cup 20752 of the second distal shaft member 20750 therein. Thethird spherical distal end 20840 is movably pinned within a third distalsocket 20852 on a third distal shaft 20850. The third spherical distalend 20840 is axially movable within the third distal socket 20852 and isattached thereto by third distal pin segments 20846 that extend from thethird spherical distal end 20840 to be movably received withincorresponding axial slots 20854 in the third distal socket 20850.

In one arrangement, the third distal shaft member 20850 may beconfigured to apply rotary motions to the surgical end effector 20000 torotate the surgical end effector 20000 about the shaft axis SA. In onearrangement, for example, the third distal shaft member 20850 may bedirectly attached to (welded) the elongate channel 20100. Thus, in atleast one arrangement, actuation of the third rotary drive system tocause rotation of the third proximal shaft member 20820 will result inrotation of the third distal shaft member 20850 and the surgical endeffector 20000. In the illustrated arrangement, the intermeshing gearteeth 20522 and 20552 on the upper proximal pivot tang 20520 and upperdistal pivot tang 20550 force the centers of the shaft systems to stayin the same center distance when undergoing articulation. Such shaftsystems are very strong and robust while maintaining a tightarticulation joint while also facilitating distal roll of the surgicalend effector.

Highly articulated robotic and handheld endo mechanical staplers need togenerate a lot of force to clamp onto thick tissue. Moving forcesthrough a highly articulated joint (sixty degrees and greater forexample) is challenging. Many robotic and handheld motors are slow andtheir ability to produce sufficient torque is limited. FIGS. 69-75illustrate a surgical end effector 21000 that can address many of notall of those challenges. As can be seen in FIG. 69 , the surgical endeffector 21000 comprises a first jaw 21100 that comprises an elongatechannel 21110 that is configured to operably support a surgical staplecartridge 21300 therein. The surgical end effector 21000 furthercomprises a second jaw 21200 that comprises an anvil 21210 that ispivotally coupled to the elongate channel 21110 about a fixed pivot axisPA. The anvil 21210 is pivotable between an open position (FIG. 71 ) anda closed position (FIG. 70 ) by a rotary driven closure system 21400.

In one arrangement, the closure system 21400 comprises a closure driveshaft 21410 that is configured to be rotated by a corresponding sourceof rotary motion (motor, etc.) in the housing of the surgical instrumentto which the surgical end effector is attached. The closure drive shaft21410 may comprises a flexible shaft arrangement that can flex whiletransferring torque through an articulation joint. The closure driveshaft 21410 is attached to a rotary cam shaft 21420 that has a closurecam lobe 21422 formed thereon. In one arrangement, an opening bushing21430 is movably journaled on the rotary cam shaft 21420 and isconfigured to engage an opening tab 21222 on an anvil mounting portion21220 of the anvil 21210. An opening spring 21440 is positioned on therotary cam shaft 21420 to bias the opening bushing 21430 distally intocontact with the opening tab 21222 on the anvil 21210. As can be seen inFIG. 70 , as the opening bushing 21430 moves distally, it contacts theopening tab 21222 which causes the anvil 21210 to pivot about the pivotaxis PA to the open position (FIG. 71 ).

In one example, the anvil 21210 is pivoted from the open position to aclosed position by rotating the rotary cam shaft 21420 from a firstrotary position shown in FIG. 72 to a final rotary position shown inFIG. 74 . As can be seen in FIGS. 69 and 70 , the closure system 21400further comprises a cam follower 21450 that is movably supported in theanvil mounting portion 21220 and is configured for movable engagementwith the closure cam lobe 21422 on the rotary cam shaft 21420. FIGS. 71and 72 illustrate the position of the closure cam lobe 21422 when theanvil 21210 is in the open position. When in that position, the anvilmounting portion 21220 has pivoted past the closure cam lobe 21422 suchthat the cam follower 21450 is not contacted by the closure cam lobe21422. As the rotary cam shaft 21420 begins to rotate, the closure canlobe 21422 contacts the cam follower 21450 (FIG. 73 ) and cams the camfollower 21450 into contact with a pivot cradle 12224 in the anvilmounting portion 21220 (upward in FIG. 73 ) to the position shown inFIG. 74 wherein the cam follower 21452 has pivoted the anvil 21210 tothe closed position (FIG. 75 ). As the anvil 21210 pivots to the closedposition, the opening tab 21222 biases the opening bushing 21430proximally on the rotary cam shaft 21420 against the bias of the openingspring 21440. Thus, when the rotary cam shaft 21420 is rotated in anopposite direction, the anvil opening spring 21440 biases the openingbushing 21430 distally into contact with the opening tab 21222 to pivotthe anvil 21210 back to the open position.

FIG. 76 illustrates another rotary cam shaft 21420′ that is identical tothe rotary cam shaft 21420 except that a distal end 21426 of the rotarycam shaft 21420′ further comprises an opening cam 21426 that isconfigured to engage the opening tab 21222 on the anvil 21210 to movethe anvil 21210 to an open position. Thus, when the rotary cam shaft21420′ is in a first rotary position, the opening cam 21426 has cammedthe anvil opening tab 21222 to pivot the anvil 21210 to the openposition. See FIG. 77 . To close the anvil, the rotary cam shaft 21420′is rotated in a closure direction to cause the cam lobe 21422 to cam thecam follower 21450 upward to pivot the anvil 21210 into the closedposition. The anvil 21210 can then be returned to the open position byrotating the rotary cam shaft 21420′ back to the first rotary position.In alternative arrangements, the opening bushing 21430 and openingspring 21440 may be used in conjunction with the rotary cam shaft21420′.

It will be appreciated that the foregoing embodiments of the closuresystem 21400 facilitates the application of relatively quick closure andopening motions to the anvil 21210. In various arrangements, the camprofile(s) may be formed to establish a low mechanical advantage at thestart and a relatively high mechanical advantage at the end when theanvil 21210 starts to compress tissue. Such closure system arrangementemploys fewer components than many other closure system designs. Thisarrangement also provides additional space at the proximal end of theend effector to accommodate electronics and other mechanisms in the endeffector.

Example 1—A surgical instrument comprising a shaft assembly that definesa shaft axis. The surgical instrument further comprises a surgical endeffector that defines an end effector axis and is coupled to the shaftassembly by an articulation joint that is configured to facilitatearticulation of the surgical end effector relative to the shaft assemblyin an articulation plane between an unarticulated position wherein theend effector axis is axially aligned with the shaft axis and articulatedpositions wherein the end effector axis is not axially aligned with theshaft axis. The articulation joint comprises a proximal joint memberthat is coupled to the shaft assembly and a distal joint member that iscoupled to the surgical end effector. The articulation joint furthercomprises an articulation linkage assembly that comprising a pluralityof links. Each link is configured to operably interface with theproximal joint member for movable travel relative thereto in a firstproximal travel path and a second proximal travel path that istransverse to the first proximal travel path. Each link is furtherconfigured to operably interface with the distal joint member formovable travel relative thereto in a first distal travel path and asecond distal travel path that is transverse to the first distal travelpath. The articulation linkage assembly defines a central passage thatextends between the plurality of links. The surgical instrument furthercomprises a drive member that extends through the proximal joint member,the central passage and the distal joint member to operably interfacewith the surgical end effector. At least two flexible actuator membersspan the articulation joint and operably interface with the distal jointmember to apply articulation motions thereto.

Example 2—The surgical instrument of Example 1, wherein the plurality oflinks comprises three links.

Example 3—The surgical instrument of Example 2, wherein the three linkscomprises a first link that is configured to operably interface with theproximal joint member for movable travel relative thereto in a firstproximal travel path and another first proximal travel path that istransverse to the first proximal travel path. The first link is furtherconfigured to operably interface with the distal joint member formovable travel relative thereto in a first distal travel path andanother first distal travel path that is transverse to the first distaltravel path. The three links further comprise a second link that isconfigured to operably interface with the proximal joint member formovable travel relative thereto in a second proximal travel path andanother second proximal travel path that is transverse to the secondproximal travel path. The second link is configured to operablyinterface with the distal joint member for movable travel relativethereto in a second distal travel path and another second distal travelpath that is transverse to the second distal travel path. The threelinks further comprise a third link that is configured to operablyinterface with the proximal joint member for movable travel relativethereto in a third proximal travel path and another third travel paththat is transverse to the third proximal travel path. The third link isfurther configured to operably interface with the distal joint memberfor movable travel relative thereto in a third distal travel path andanother third distal travel path that is transverse to the third distaltravel path.

Example 4—The surgical instrument of Examples 1, 2 or 3, wherein eachlink comprises a proximal saddle that is configured to movably interfacewith a corresponding proximal mounting lug on the proximal joint memberand a distal saddle that is configured to movably interface with acorresponding distal mounting lug on the distal joint member.

Example 5—The surgical instrument of Example 4, wherein each proximalmounting lug defines an arcuate proximal pivot surface. Each proximalsaddle comprises a U-shaped proximal pivot surface that is configured tomovably interface with the arcuate proximal pivot surface on theproximal mounting lug to facilitate travel of the link in the firstproximal travel path and the second proximal travel path on the proximalmounting lug. Each distal mounting lug defines an arcuate distal pivotsurface. Each distal saddle comprises a U-shaped distal pivot surfacethat is configured to movably interface with the arcuate distal pivotsurface on the distal mounting lug to facilitate travel of the link inthe first distal travel path and the second distal travel path on thedistal mounting lug.

Example 6—The surgical instrument of Example 5, wherein each proximalmounting lug defines a proximal lug axis and wherein the first proximaltravel path comprises a first arcuate proximal travel path along theproximal lug axis. The second proximal travel path comprises a secondarcuate proximal travel path around the proximal lug axis. Each distalmounting lug defines a distal lug axis and wherein the first distaltravel path comprises a first arcuate distal travel path along thedistal lug axis. The second distal travel path comprises a secondarcuate distal travel path around said distal lug axis.

Example 7—The surgical instrument of Examples 1, 2, 3, 4 or 6, wherein aportion of the drive member that extends through the articulation jointis flexible.

Example 8—The surgical instrument of Examples 1, 2, 3, 4, 5, 6 or 7,wherein the drive member comprises a proximal drive shaft that includesa distal end that is operably supported in the proximal joint member. Adistal drive shaft comprises a proximal end that is operably supportedin the distal joint member. A central drive shaft spans between theproximal joint member and the distal joint member distal and comprises aproximal end that is configured to operably interface with the distalend of the proximal drive shaft. The central drive shaft furthercomprises a distal end that is configured to operably interface with theproximal end of the distal drive shaft.

Example 9—The surgical instrument of Example 8, wherein the proximaldrive shaft is configured to apply rotary drive motions to the centraldrive shaft.

Example 10—The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8 or9, wherein the at least two flexible actuator members comprises fourcables that span the articulation joint and operably interface with thedistal articulation joint member to apply articulation motions thereto.

Example 11—The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9or 10, wherein each link is not attached to the proximal joint memberand the distal joint member.

Example 12—The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8,9, 10 or 11, wherein each link is retained in movable contact with theproximal joint member and the distal joint member.

Example 13—A surgical instrument comprising a shaft assembly thatdefines a shaft axis and a surgical end effector that defines an endeffector axis. The surgical end effector is coupled to the shaftassembly by an articulation joint that is configured to facilitatearticulation of the surgical end effector relative to the shaft assemblyin an articulation plane between an unarticulated position wherein theend effector axis is axially aligned with the shaft axis in thearticulation plane and articulated positions wherein the end effectoraxis is not axially aligned with the shaft axis. The articulation jointcomprises a proximal joint member that is coupled to the shaft assemblyand a distal joint member that is coupled to the surgical end effector.The articulation joint further comprises an articulation linkageassembly that comprises a first link that is configured to operablyinterface with the proximal joint member for movable travel relativethereto in a first proximal travel path and another first proximaltravel path that is transverse to the first proximal travel path. Thefirst link is further configured to operably interface with the distaljoint member for movable travel relative thereto in a first distaltravel path and another first distal travel path that is transverse tothe first distal travel path. The articulation linkage assembly furthercomprises a second link that is configured to operably interface withthe proximal joint member for movable travel relative thereto in asecond proximal travel path and another second proximal travel path thatis transverse to the second proximal travel path. The second link isfurther configured to operably interface with the distal joint memberfor movable travel relative thereto in a second distal travel path andanother second distal travel path that is transverse to the seconddistal travel path. The articulation linkage assembly further comprisesa third link that is configured to operably interface with the proximaljoint member for movable travel relative thereto in a third proximaltravel path and another third travel path that is transverse to thethird proximal travel path. The third link is further configured tooperably interface with the distal joint member for movable travelrelative thereto in a third distal travel path and another third distaltravel path that is transverse to the third distal travel path. Thesurgical instrument further comprises at least two flexible actuatormembers that span the articulation joint and operably interface with thedistal joint member to apply articulation motions thereto.

Example 14—The surgical instrument of Example 13, wherein the first linkdefines a first link axis. The second link defines a second link axis.The third link defines a third link axis. The first link axis, thesecond link axis, and the third link axis are transverse to each other.

Example 15—The surgical instrument of Examples 13 or 14, wherein thefirst link, the second link, and the third link are arranged relative toeach other to define a central passage that extends between the firstlink, the second link, and the third link and is configured to operablysupport a drive member therein.

Example 16—The surgical instrument of Examples 13, 14 or 15, wherein thefirst link comprises a first proximal saddle that is configured tomovably interface with a corresponding first proximal mounting lug onthe proximal joint and a first distal saddle that is configured tomovably interface with a corresponding first distal mounting lug on thedistal joint. The second link comprises a second proximal saddle that isconfigured to movably interface with a corresponding second proximalmounting lug on the proximal joint and a second distal saddle that isconfigured to movably interface with a corresponding second distalmounting lug on the distal joint. The third link comprises a thirdproximal saddle that is configured to movably interface with acorresponding third proximal mounting lug on the proximal joint and athird distal saddle that is configured to movably interface with acorresponding third distal mounting lug on the distal joint.

Example 17—The surgical instrument of Example 16, wherein the firstproximal mounting lug defines a first arcuate proximal pivot surface.The first proximal saddle comprises a first U-shaped proximal pivotsurface that is configured to movably interface with the first arcuateproximal pivot surface on the first proximal mounting lug to facilitatetravel of the first link in the first proximal travel path and anotherfirst proximal travel path on the first proximal mounting lug. Thesecond proximal mounting lug defines a second arcuate proximal pivotsurface. The second proximal saddle comprises a second U-shaped proximalpivot surface that is configured to movably interface with the secondarcuate proximal pivot surface on the second proximal mounting lug tofacilitate travel of the second link in the second proximal travel pathand another second proximal travel path on the second proximal mountinglug. The third proximal mounting lug defines a third arcuate proximalpivot surface. The third proximal saddle comprises a third U-shapedproximal pivot surface that is configured to movably interface with thethird arcuate proximal pivot surface on the third proximal mounting lugto facilitate travel of the third link in the third proximal travel pathand another third proximal travel path on the third proximal mountinglug.

Example 18—The surgical instrument of Example 17, wherein the firstdistal mounting lug defines a first arcuate distal pivot surface. Thefirst distal saddle comprises a first U-shaped distal pivot surface thatis configured to movably interface with the first arcuate distal pivotsurface on the first distal mounting lug to facilitate travel of thefirst link in the first distal travel path and another first distaltravel path on the first distal mounting lug. The second distal mountinglug defines a second arcuate distal pivot surface. The second distalsaddle comprises a second U-shaped distal pivot surface that isconfigured to movably interface with the second arcuate distal pivotsurface on the second distal mounting lug to facilitate travel of thesecond link in the second distal travel path and another second distaltravel path on the second distal mounting lug. The third distal mountinglug defines a third arcuate distal pivot surface. The third distalsaddle comprises a third U-shaped distal pivot surface that isconfigured to movably interface with the third arcuate distal pivotsurface on the third distal mounting lug to facilitate travel of thethird link in the third distal travel path and another third distaltravel path on the third distal mounting lug.

Example 19—The surgical instrument of Example 18, wherein the firstproximal mounting lug defines a first proximal lug axis. The firstproximal travel path comprises a first arcuate proximal travel pathalong the first proximal lug axis and the another first proximal travelpath comprises another first proximal arcuate travel path that extendsaround the first proximal lug axis. The second proximal mounting lugdefines a second proximal lug axis. The second proximal travel pathcomprises a second arcuate proximal travel path along the secondproximal lug axis and the another second proximal travel path comprisesanother second proximal arcuate travel path that extends around thesecond proximal lug axis. The third proximal mounting lug defines athird proximal lug axis. The third proximal travel path comprises athird arcuate proximal travel path that extends along the third proximallug axis. The another third proximal travel path comprises another thirdproximal arcuate travel path that extends around the third proximal lugaxis. The first distal mounting lug defines a first distal lug axis. Thefirst distal travel path comprises a first arcuate distal travel paththat extends along said first distal lug axis. The another first distaltravel path comprises another first distal arcuate travel path thatextends around the first distal lug axis. The second distal mounting lugdefines a second distal lug axis. The second distal travel pathcomprises a second arcuate distal travel path that extends along thesecond distal lug axis. The another second distal travel path comprisesanother second distal arcuate travel path that extends along the seconddistal lug axis. The third distal mounting lug defines a third distallug axis. The third distal travel path comprises a third arcuate distaltravel path that extends along the third distal lug axis. The anotherthird distal travel path comprises another third distal arcuate travelpath that extends around the third distal lug axis.

Example 20—The surgical instrument of Example 19, wherein the firstproximal lug axis, the second proximal lug axis, and the third proximallug axis are transverse to each other and wherein the first distal lugaxis, the second distal lug axis, and the third distal lug axis aretransverse to each other.

As used in any aspect herein, the term “control circuit” may refer to,for example, hardwired circuitry, programmable circuitry (e.g., acomputer processor including one or more individual instructionprocessing cores, processing unit, processor, microcontroller,microcontroller unit, controller, digital signal processor (DSP),programmable logic device (PLD), programmable logic array (PLA), orfield programmable gate array (FPGA)), state machine circuitry, firmwarethat stores instructions executed by programmable circuitry, and anycombination thereof. The control circuit may, collectively orindividually, be embodied as circuitry that forms part of a largersystem, for example, an integrated circuit (IC), an application-specificintegrated circuit (ASIC), a system on-chip (SoC), desktop computers,laptop computers, tablet computers, servers, smart phones, etc.Accordingly, as used herein “control circuit” includes, but is notlimited to, electrical circuitry having at least one discrete electricalcircuit, electrical circuitry having at least one integrated circuit,electrical circuitry having at least one application specific integratedcircuit, electrical circuitry forming a general purpose computing deviceconfigured by a computer program (e.g., a general purpose computerconfigured by a computer program which at least partially carries outprocesses and/or devices described herein, or a microprocessorconfigured by a computer program which at least partially carries outprocesses and/or devices described herein), electrical circuitry forminga memory device (e.g., forms of random access memory), and/or electricalcircuitry forming a communications device (e.g., a modem, communicationsswitch, or optical-electrical equipment). Those having skill in the artwill recognize that the subject matter described herein may beimplemented in an analog or digital fashion or some combination thereof.

While several forms have been illustrated and described, it is not theintention of Applicant to restrict or limit the scope of the appendedclaims to such detail. Numerous modifications, variations, changes,substitutions, combinations, and equivalents to those forms may beimplemented and will occur to those skilled in the art without departingfrom the scope of the present disclosure. Moreover, the structure ofeach element associated with the described forms can be alternativelydescribed as a means for providing the function performed by theelement. Also, where materials are disclosed for certain components,other materials may be used. It is therefore to be understood that theforegoing description and the appended claims are intended to cover allsuch modifications, combinations, and variations as falling within thescope of the disclosed forms. The appended claims are intended to coverall such modifications, variations, changes, substitutions,modifications, and equivalents.

One or more components may be referred to herein as “configured to,”“configurable to,” “operable/operative to,” “adapted/adaptable,” “ableto,” “conformable/conformed to,” etc. Those skilled in the art willrecognize that “configured to” can generally encompass active-statecomponents and/or inactive-state components and/or standby-statecomponents, unless context requires otherwise.

Those skilled in the art will recognize that, in general, terms usedherein, and especially in the appended claims (e.g., bodies of theappended claims) are generally intended as “open” terms (e.g., the term“including” should be interpreted as “including but not limited to,” theterm “having” should be interpreted as “having at least,” the term“includes” should be interpreted as “includes but is not limited to,”etc.). It will be further understood by those within the art that if aspecific number of an introduced claim recitation is intended, such anintent will be explicitly recited in the claim, and in the absence ofsuch recitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases “at least one” and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles “a” or “an” limits any particular claim containing suchintroduced claim recitation to claims containing only one suchrecitation, even when the same claim includes the introductory phrases“one or more” or “at least one” and indefinite articles such as “a” or“an” (e.g., “a” and/or “an” should typically be interpreted to mean “atleast one” or “one or more”); the same holds true for the use ofdefinite articles used to introduce claim recitations.

In addition, even if a specific number of an introduced claim recitationis explicitly recited, those skilled in the art will recognize that suchrecitation should typically be interpreted to mean at least the recitednumber (e.g., the bare recitation of “two recitations,” without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to “at least one of A, B, and C, etc.” is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., “a system having at least one ofA, B, and C” would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to “at least one of A, B, or C, etc.” is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., “a system having at leastone of A, B, or C” would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that typically a disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms unless context dictates otherwise. For example, the phrase “Aor B” will be typically understood to include the possibilities of “A”or “B” or “A and B.”

With respect to the appended claims, those skilled in the art willappreciate that recited operations therein may generally be performed inany order. Also, although various operational flow diagrams arepresented in a sequence(s), it should be understood that the variousoperations may be performed in other orders than those which areillustrated, or may be performed concurrently. Examples of suchalternate orderings may include overlapping, interleaved, interrupted,reordered, incremental, preparatory, supplemental, simultaneous,reverse, or other variant orderings, unless context dictates otherwise.Furthermore, terms like “responsive to,” “related to,” or otherpast-tense adjectives are generally not intended to exclude suchvariants, unless context dictates otherwise.

It is worthy to note that any reference to “one aspect,” “an aspect,”“an exemplification,” “one exemplification,” and the like means that aparticular feature, structure, or characteristic described in connectionwith the aspect is included in at least one aspect. Thus, appearances ofthe phrases “in one aspect,” “in an aspect,” “in an exemplification,”and “in one exemplification” in various places throughout thespecification are not necessarily all referring to the same aspect.Furthermore, the particular features, structures or characteristics maybe combined in any suitable manner in one or more aspects.

Any patent application, patent, non-patent publication, or otherdisclosure material referred to in this specification and/or listed inany Application Data Sheet is incorporated by reference herein, to theextent that the incorporated materials is not inconsistent herewith. Assuch, and to the extent necessary, the disclosure as explicitly setforth herein supersedes any conflicting material incorporated herein byreference. Any material, or portion thereof, that is said to beincorporated by reference herein, but which conflicts with existingdefinitions, statements, or other disclosure material set forth hereinwill only be incorporated to the extent that no conflict arises betweenthat incorporated material and the existing disclosure material.

In summary, numerous benefits have been described which result fromemploying the concepts described herein. The foregoing description ofthe one or more forms has been presented for purposes of illustrationand description. It is not intended to be exhaustive or limiting to theprecise form disclosed. Modifications or variations are possible inlight of the above teachings. The one or more forms were chosen anddescribed in order to illustrate principles and practical application tothereby enable one of ordinary skill in the art to utilize the variousforms and with various modifications as are suited to the particular usecontemplated. It is intended that the claims submitted herewith definethe overall scope.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

Many of the surgical instrument systems described herein are motivatedby an electric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In various instances,the surgical instrument systems described herein can be motivated by amanually-operated trigger, for example. In certain instances, the motorsdisclosed herein may comprise a portion or portions of a roboticallycontrolled system. Moreover, any of the end effectors and/or toolassemblies disclosed herein can be utilized with a robotic surgicalinstrument system. U.S. patent application Ser. No. 13/118,241, entitledSURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, disclosesseveral examples of a robotic surgical instrument system in greaterdetail.

The entire disclosures of:

-   U.S. Pat. No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC DEVICE,    which issued on Apr. 4, 1995;-   U.S. Pat. No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT    HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which issued on    Feb. 21, 2006;-   U.S. Pat. No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING AND    FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which issued on    Sep. 9, 2008;-   U.S. Pat. No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL    INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, which    issued on Dec. 16, 2008;-   U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN    ARTICULATING END EFFECTOR, which issued on Mar. 2, 2010;-   U.S. Pat. No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS,    which issued on Jul. 13, 2010;-   U.S. Pat. No. 8,393,514, entitled SELECTIVELY ORIENTABLE IMPLANTABLE    FASTENER CARTRIDGE, which issued on Mar. 12, 2013;-   U.S. patent application Ser. No. 11/343,803, entitled SURGICAL    INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No.    7,845,537;-   U.S. patent application Ser. No. 12/031,573, entitled SURGICAL    CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed Feb.    14, 2008;-   U.S. patent application Ser. No. 12/031,873, entitled END EFFECTORS    FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed Feb. 15, 2008,    now U.S. Pat. No. 7,980,443;-   U.S. patent application Ser. No. 12/235,782, entitled MOTOR-DRIVEN    SURGICAL CUTTING INSTRUMENT, now U.S. Pat. No. 8,210,411;-   U.S. patent application Ser. No. 12/235,972, entitled MOTORIZED    SURGICAL INSTRUMENT, now U.S. Pat. No. 9,050,083;-   U.S. patent application Ser. No. 12/249,117, entitled POWERED    SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE    FIRING SYSTEM, now U.S. Pat. No. 8,608,045;-   U.S. patent application Ser. No. 12/647,100, entitled MOTOR-DRIVEN    SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL    CONTROL ASSEMBLY, filed Dec. 24, 2009, now U.S. Pat. No. 8,220,688;-   U.S. patent application Ser. No. 12/893,461, entitled STAPLE    CARTRIDGE, filed Sep. 29, 2012, now U.S. Pat. No. 8,733,613;-   U.S. patent application Ser. No. 13/036,647, entitled SURGICAL    STAPLING INSTRUMENT, filed Feb. 28, 2011, now U.S. Pat. No.    8,561,870;-   U.S. patent application Ser. No. 13/118,241, entitled SURGICAL    STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,    now U.S. Pat. No. 9,072,535;-   U.S. patent application Ser. No. 13/524,049, entitled ARTICULATABLE    SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, filed on Jun. 15,    2012, now U.S. Pat. No. 9,101,358;-   U.S. patent application Ser. No. 13/800,025, entitled STAPLE    CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013,    now U.S. Pat. No. 9,345,481;-   U.S. patent application Ser. No. 13/800,067, entitled STAPLE    CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013,    now U.S. Patent Application Publication No. 2014/0263552, now    abandoned;-   U.S. Patent Application Publication No. 2007/0175955, entitled    SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER    LOCKING MECHANISM, filed Jan. 31, 2006, now abandoned; and-   U.S. Patent Application Publication No. 2010/0264194, entitled    SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR,    filed Apr. 22, 2010, now U.S. Pat. No. 8,308,040, are hereby    incorporated by reference herein.

Although various devices have been described herein in connection withcertain embodiments, modifications and variations to those embodimentsmay be implemented. Particular features, structures, or characteristicsmay be combined in any suitable manner in one or more embodiments. Thus,the particular features, structures, or characteristics illustrated ordescribed in connection with one embodiment may be combined in whole orin part, with the features, structures or characteristics of one or moreother embodiments without limitation. Also, where materials aredisclosed for certain components, other materials may be used.Furthermore, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Theforegoing description and following claims are intended to cover allsuch modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

What is claimed is:
 1. A surgical instrument, comprising: a shaftassembly, wherein said shaft assembly defines a shaft axis; a surgicalend effector, wherein said surgical end effector defines an end effectoraxis, wherein said surgical end effector is coupled to said shaftassembly by an articulation joint configured to facilitate articulationof said surgical end effector relative to said shaft assembly in anarticulation plane between an unarticulated position wherein said endeffector axis is axially aligned with said shaft axis and articulatedpositions wherein said end effector axis is not axially aligned withsaid shaft axis, wherein said articulation joint comprises: a proximaljoint member coupled to said shaft assembly; a distal joint membercoupled to said surgical end effector; and an articulation linkageassembly comprising a plurality of links, wherein each said link isconfigured to operably interface with said proximal joint member formovable travel relative thereto in a first proximal travel path and asecond proximal travel path that is transverse to said first proximaltravel path, and wherein each said link is configured to operablyinterface with said distal joint member for movable travel relativethereto in a first distal travel path and a second distal travel paththat is transverse to said first distal travel path, wherein saidarticulation linkage assembly defines a central passage extendingbetween said plurality of links, and wherein said surgical instrumentfurther comprises: a drive member extending through said proximal jointmember, said central passage and said distal joint member to operablyinterface with said surgical end effector; and at least two flexibleactuator members spanning said articulation joint and operablyinterfacing with said distal joint member to apply articulation motionsthereto.
 2. The surgical instrument of claim 1, wherein said pluralityof links comprises three links.
 3. The surgical instrument of claim 2,wherein said three links comprises: a first link configured to operablyinterface with said proximal joint member for movable travel relativethereto in a first proximal travel path and another first proximaltravel path that is transverse to said first proximal travel path, andwherein said first link is configured to operably interface with saiddistal joint member for movable travel relative thereto in a firstdistal travel path and another first distal travel path that istransverse to said first distal travel path; a second link configured tooperably interface with said proximal joint member for movable travelrelative thereto in a second proximal travel path and another secondproximal travel path that is transverse to said second proximal travelpath, and wherein said second link is configured to operably interfacewith said distal joint member for movable travel relative thereto in asecond distal travel path and another second distal travel path that istransverse to said second distal travel path; and a third linkconfigured to operably interface with said proximal joint member formovable travel relative thereto in a third proximal travel path andanother third travel path that is transverse to said third proximaltravel path, and wherein said third link is configured to operablyinterface with said distal joint member for movable travel relativethereto in a third distal travel path and another third distal travelpath that is transverse to said third distal travel path.
 4. Thesurgical instrument of claim 1, wherein each said link comprises: aproximal saddle configured to movably interface with a correspondingproximal mounting lug on said proximal joint member; and a distal saddleconfigured to movably interface with a corresponding distal mounting lugon said distal joint member.
 5. The surgical instrument of claim 4,wherein each said proximal mounting lug defines an arcuate proximalpivot surface, wherein each said proximal saddle comprises a U-shapedproximal pivot surface configured to movably interface with said arcuateproximal pivot surface on said proximal mounting lug to facilitatetravel of said link in said first proximal travel path and said secondproximal travel path on said proximal mounting lug, wherein each saiddistal mounting lug defines an arcuate distal pivot surface, whereineach said distal saddle comprises a U-shaped distal pivot surfaceconfigured to movably interface with said arcuate distal pivot surfaceon said distal mounting lug to facilitate travel of said link in saidfirst distal travel path and said second distal travel path on saiddistal mounting lug.
 6. The surgical instrument of claim 5, wherein eachsaid proximal mounting lug defines a proximal lug axis, wherein saidfirst proximal travel path comprises a first arcuate proximal travelpath along said proximal lug axis, wherein said second proximal travelpath comprises a second arcuate proximal travel path around saidproximal lug axis, wherein each said distal mounting lug defines adistal lug axis, wherein said first distal travel path comprises a firstarcuate distal travel path along said distal lug axis, and wherein saidsecond distal travel path comprises a second arcuate distal travel patharound said distal lug axis.
 7. The surgical instrument of claim 1,wherein a portion of said drive member extending through saidarticulation joint is flexible.
 8. The surgical instrument of claim 1,wherein said drive member comprises: a proximal drive shaft comprising adistal end operably supported in said proximal joint member; a distaldrive shaft comprising a proximal end operably supported in said distaljoint member; and a central drive shaft spanning between said proximaljoint member and said distal joint member distal, wherein said centraldrive shaft comprises a proximal end configured to operably interfacewith said distal end of said proximal drive shaft, and wherein saidcentral drive shaft further comprises a distal end configured tooperably interface with said proximal end of said distal drive shaft. 9.The surgical instrument of claim 8, wherein said proximal drive shaft isconfigured to apply rotary drive motions to said central drive shaft.10. The surgical instrument of claim 1, wherein said at least twoflexible actuator members comprises four cables spanning saidarticulation joint and operably interfacing with said distalarticulation joint member to apply articulation motions thereto.
 11. Thesurgical instrument of claim 10, wherein each link of said plurality oflinks is not attached to said proximal joint member and said distaljoint member.
 12. The surgical instrument of claim 11, wherein each saidlink of said plurality of links is retained in movable contact with saidproximal joint member and said distal joint member.
 13. A surgicalinstrument, comprising: a shaft assembly, wherein said shaft assemblydefines a shaft axis; a surgical end effector, wherein said surgical endeffector defines an end effector axis, wherein said surgical endeffector is coupled to said shaft assembly by an articulation jointconfigured to facilitate articulation of said surgical end effectorrelative to said shaft assembly in an articulation plane between anunarticulated position wherein said end effector axis is axially alignedwith said shaft axis in said articulation plane and articulatedpositions wherein said end effector axis is not axially aligned withsaid shaft axis, wherein said articulation joint comprises: a proximaljoint member coupled to said shaft assembly; a distal joint membercoupled to said surgical end effector; and an articulation linkageassembly comprising: a first link configured to operably interface withsaid proximal joint member for movable travel relative thereto in afirst proximal travel path and another first proximal travel path thatis transverse to said first proximal travel path, and wherein said firstlink is configured to operably interface with said distal joint memberfor movable travel relative thereto in a first distal travel path andanother first distal travel path that is transverse to said first distaltravel path; a second link configured to operably interface with saidproximal joint member for movable travel relative thereto in a secondproximal travel path and another second proximal travel path that istransverse to said second proximal travel path, and wherein said secondlink is configured to operably interface with said distal joint memberfor movable travel relative thereto in a second distal travel path andanother second distal travel path that is transverse to said seconddistal travel path; and a third link configured to operably interfacewith said proximal joint member for movable travel relative thereto in athird proximal travel path and another third travel path that istransverse to said third proximal travel path, and wherein said thirdlink is configured to operably interface with said distal joint memberfor movable travel relative thereto in a third distal travel path andanother third distal travel path that is transverse to said third distaltravel path, wherein said surgical instrument further comprises at leasttwo flexible actuator members, and wherein said at least two flexibleactuator members span said articulation joint and operably interfacewith said distal joint member to apply articulation motions thereto. 14.The surgical instrument of claim 13, wherein said first link defines afirst link axis, wherein said second link defines a second link axis,wherein said third link defines a third link axis, and wherein saidfirst link axis, said second link axis, and said third link axis aretransverse to each other.
 15. The surgical instrument of claim 14,wherein said first link, said second link, and said third link arearranged relative to each other to define a central passage that extendsbetween said first link, said second link, and said third link, whereinsaid central passage is configured to operably support a drive membertherein.
 16. The surgical instrument of claim 13, wherein said firstlink comprises: a first proximal saddle configured to movably interfacewith a corresponding first proximal mounting lug on said proximal joint;and a first distal saddle configured to movably interface with acorresponding first distal mounting lug on said distal joint, whereinsaid second link comprises: a second proximal saddle configured tomovably interface with a corresponding second proximal mounting lug onsaid proximal joint; and a second distal saddle configured to movablyinterface with a corresponding second distal mounting lug on said distaljoint, and wherein said third link comprises: a third proximal saddleconfigured to movably interface with a corresponding third proximalmounting lug on said proximal joint; and a third distal saddleconfigured to movably interface with a corresponding third distalmounting lug on said distal joint.
 17. The surgical instrument of claim16, wherein said first proximal mounting lug defines a first arcuateproximal pivot surface, wherein said first proximal saddle comprises afirst U-shaped proximal pivot surface configured to movably interfacewith said first arcuate proximal pivot surface on said first proximalmounting lug to facilitate travel of said first link in said firstproximal travel path and said another first proximal travel path on saidfirst proximal mounting lug, wherein said second proximal mounting lugdefines a second arcuate proximal pivot surface, wherein said secondproximal saddle comprises a second U-shaped proximal pivot surfaceconfigured to movably interface with said second arcuate proximal pivotsurface on said second proximal mounting lug to facilitate travel ofsaid second link in said second proximal travel path and said anothersecond proximal travel path on said second proximal mounting lug, andwherein said third proximal mounting lug defines a third arcuateproximal pivot surface, wherein said third proximal saddle comprises athird U-shaped proximal pivot surface configured to movably interfacewith said third arcuate proximal pivot surface on said third proximalmounting lug to facilitate travel of said third link in said thirdproximal travel path and said another third proximal travel path on saidthird proximal mounting lug.
 18. The surgical instrument of claim 17,wherein said first distal mounting lug defines a first arcuate distalpivot surface, wherein said first distal saddle comprises a firstU-shaped distal pivot surface configured to movably interface with saidfirst arcuate distal pivot surface on said first distal mounting lug tofacilitate travel of said first link in said first distal travel pathand said another first distal travel path on said first distal mountinglug, wherein said second distal mounting lug defines a second arcuatedistal pivot surface, wherein said second distal saddle comprises asecond U-shaped distal pivot surface configured to movably interfacewith said second arcuate distal pivot surface on said second distalmounting lug to facilitate travel of said second link in said seconddistal travel path and said another second distal travel path on saidsecond distal mounting lug, and wherein said third distal mounting lugdefines a third arcuate distal pivot surface, wherein said third distalsaddle comprises a third U-shaped distal pivot surface configured tomovably interface with said third arcuate distal pivot surface on saidthird distal mounting lug to facilitate travel of said third link insaid third distal travel path and said another third distal travel pathon said third distal mounting lug.
 19. The surgical instrument of claim18, wherein said first proximal mounting lug defines a first proximallug axis, wherein said first proximal travel path comprises a firstarcuate proximal travel path along said first proximal lug axis, whereinsaid another first proximal travel path comprises another first proximalarcuate travel path around said first proximal lug axis, wherein saidsecond proximal mounting lug defines a second proximal lug axis, whereinsaid second proximal travel path comprises a second arcuate proximaltravel path along said second proximal lug axis, wherein said anothersecond proximal travel path comprises another second proximal arcuatetravel path extending around said second proximal lug axis, wherein saidthird proximal mounting lug defines a third proximal lug axis, whereinsaid third proximal travel path comprises a third arcuate proximaltravel path along said third proximal lug axis, wherein said anotherthird proximal travel path comprises another third proximal arcuatetravel path extending around said third proximal lug axis, wherein saidfirst distal mounting lug defines a first distal lug axis, wherein saidfirst distal travel path comprises a first arcuate distal travel pathalong said first distal lug axis, wherein said another first distaltravel path comprises another first distal arcuate travel path extendingaround said first distal lug axis, wherein said second distal mountinglug defines a second distal lug axis, wherein said second distal travelpath comprises a second arcuate distal travel path along said seconddistal lug axis, wherein said another second distal travel pathcomprises another second distal arcuate travel path extending along saidsecond distal lug axis, wherein said third distal mounting lug defines athird distal lug axis, wherein said third distal travel path comprises athird arcuate distal travel path along said third distal lug axis,wherein said another third distal travel path comprises another thirddistal arcuate travel path extending around said third distal lug axis.20. The surgical instrument of claim 19, wherein said first proximal lugaxis, said second proximal lug axis, and said third proximal lug axisare transverse to each other, and wherein said first distal lug axis,said second distal lug axis, and said third distal lug axis aretransverse to each other.